|
1
|
Baptista PM, Diaz Zufiaurre N, Garaycochea O, Alcalde Navarrete JM, Moffa A, Giorgi L, Casale M, O’Connor-Reina C, Plaza G. TORS as Part of Multilevel Surgery in OSA: The Importance of Careful Patient Selection and Outcomes. J Clin Med 2022; 11:jcm11040990. [PMID: 35207264 PMCID: PMC8878188 DOI: 10.3390/jcm11040990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/28/2022] [Accepted: 02/04/2022] [Indexed: 12/10/2022] Open
Abstract
Transoral robotic surgery (TORS) for Obstructive Sleep Apnea (OSA) is a relatively young technique principally devised for managing apneas in the tongue base area. This study summarizes and presents our personal experience with TORS for OSA treatment, with the aim to provide information regarding its safety, efficacy, and postoperative complications. A retrospective study was conducted on patients undergoing TORS with lingual tonsillectomy through the Da Vinci robot. The effectiveness of the surgical procedure was assessed employing the Epworth Sleepiness Scale (ESS) and overnight polysomnography with the Apnea-Hypopnea Index (AHI). A total of 57 patients were included. Eighteen patients (31.6%) had undergone previous surgery. The mean time of TORS procedure was 30 min. Base of tongue (BOT) management was associated with other procedures in all patients: pharyngoplasty (94%), tonsillectomy (66%), and septoplasty (58%). At 6 months follow-up visit, there was a significant improvement in AHI values (from 38.62 ± 20.36 to 24.33 ± 19.68) and ESS values (from 14.25 ± 3.97 to 8.25 ± 3.3). The surgical success rate was achieved in 35.5% of patients. The most frequent major complication was bleeding, with the need for operative intervention in three cases (5.3%). The most common minor complications were mild dehydration and pain. TORS for OSA treatment appears to be an effective and safe procedure for adequately selected patients looking for an alternative therapy to CPAP.
Collapse
Affiliation(s)
- Peter M. Baptista
- Department of Otorhinolaryngology, Clinica Universidad de Navarra, Av. de Pío XII, 36, 31008 Pamplona, Spain; (P.M.B.); (N.D.Z.); (O.G.); (J.M.A.N.)
| | - Natalia Diaz Zufiaurre
- Department of Otorhinolaryngology, Clinica Universidad de Navarra, Av. de Pío XII, 36, 31008 Pamplona, Spain; (P.M.B.); (N.D.Z.); (O.G.); (J.M.A.N.)
| | - Octavio Garaycochea
- Department of Otorhinolaryngology, Clinica Universidad de Navarra, Av. de Pío XII, 36, 31008 Pamplona, Spain; (P.M.B.); (N.D.Z.); (O.G.); (J.M.A.N.)
| | - Juan Manuel Alcalde Navarrete
- Department of Otorhinolaryngology, Clinica Universidad de Navarra, Av. de Pío XII, 36, 31008 Pamplona, Spain; (P.M.B.); (N.D.Z.); (O.G.); (J.M.A.N.)
| | - Antonio Moffa
- School of Medicine, Campus Bio-Medico University, Via Alvaro del Portillo 21, 00128 Rome, Italy; (L.G.); (M.C.)
- Integrated Therapies in Otolaryngology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy
- Correspondence:
| | - Lucrezia Giorgi
- School of Medicine, Campus Bio-Medico University, Via Alvaro del Portillo 21, 00128 Rome, Italy; (L.G.); (M.C.)
- Integrated Therapies in Otolaryngology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Manuele Casale
- School of Medicine, Campus Bio-Medico University, Via Alvaro del Portillo 21, 00128 Rome, Italy; (L.G.); (M.C.)
- Integrated Therapies in Otolaryngology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Carlos O’Connor-Reina
- Otolaryngology Head and Neck Surgery, USP Hospital, Av. Severo Ochoa, 20, 29603 Marbella, Spain;
| | - Guillermo Plaza
- Department of Otolaryngology, Hospital Universitario de Fuenlabrada, Cam. del Molino, 2, 28942 Fuenlabrada, Spain;
| |
Collapse
|