Abstract
Trans oral robotic surgery is currently one of several surgical strategies in managing tongue base obstruction in sleep apnea patients. This article outlines a novel way to treat obstructive sleep apnea lingual obstruction using the da Vinci robotic surgical system. This technique offers significant potential advantages over other established approaches and it should be included in the surgical armamentarium of sleep surgeons. Despite a large body of favorable retrospective data, prospective studies are not currently available in order to evaluate the efficacy of robotic approach to tongue base as stand-alone procedure in treating sleep apnea patients.
Similar content being viewed by others
References
Papers of particular interest, published recently, have been highlighted as: • Of importance, •• Of major importance
O’Malley BW Jr, Weinstein GS, Snyder W, Hockstein NG. Transoral robotic surgery (TORS) for base of tongue neoplasms. Laryngoscope. 2006;116:1465–72.
Vicini C, Dallan I, Canzi P, Frassineti S, La Pietra MG, Montevecchi F. Transoral robotic tongue base resection in obstructive sleep apnoea-hypopnoea syndrome: a preliminary report. ORL J Otorhinolaryngol Relat Spec. 2010;72(1):22–7.
Vicini C, Frassineti S, La PietraMG, De VitoA, Dallan I, Canzi P. Tongue base reduction with Thyro-Hyoido-Pexy (TBRTHP) vs. tongue base reduction with Hyo-Epiglottoplasty (TBRHE) in mild-severe OSAHS adult treatment. Preliminary findings from a prospective randomised trial. Acta Otorhinolaryngol Ital. 2010;30:144–8.
Weinstein GS, O’Malley BW Jr, Snyder W, Hockstein NG. Transoral robotic surgery: supraglottic partial laryngectomy. Ann Otol Rhinol Laryngol. 2007;116:19–23.
Vicini C, Dallan I, Canzi P, Frassineti S, Nacci A, Seccia V, Panicucci E, Grazia La Pietra M, Montevecchi F, Tschabitscher M. Transoral robotic surgery of the tongue base in obstructive sleep apnea-hypopnea syndrome: anatomic considerations and clinical experience. Head Neck. 2012;34:15–22.
Lee JM, Weinstein GS, O’Malley BW Jr, Thaler ER. Transoral robot-assisted lingual tonsillectomy and uvulopalatopharyngoplasty for obstructive sleep apnea. Ann Otol Rhinol Laryngol. 2012;121:635–9.
•• Thaler ER, Rassekh CH, Lee JM, Weinstein GS, O’Malley BW Jr. Outcomes for multilevel surgery for sleep apnea: obstructive sleep apnea, transoral robotic surgery, and uvulopalatopharyngoplasty. Laryngoscope. 2015 [Epub ahead of print]. The article represents one of the main showing the outcomes in multilevel robotic surgery.
• Friedman M, Hamilton C, Samuelson CG, Kelley K, Taylor D, Pearson-Chauhan K, Maley A, Taylor R, Venkatesan TK. Transoral robotic glossectomy for the treatment of obstructive sleep apnea-hypopnea syndrome. Otolaryngol Head Neck Surg. 2012;146:854–62. This manuscript is one of the first report on robotic tongue base resection.
•• Vicini C, Montevecchi F, Pang K, Bahgat A, Dallan I, Frassineti S, Campanini A. Combined transoral robotic tongue base surgery and palate surgery in obstructive sleep apnea-hypopnea syndrome: expansion sphincter pharyngoplasty versus uvulopalatopharyngoplasty. Head Neck. 2014;36:77–83. This manuscript demonstrated the efficacy of the expansion sphincter pharyngoplasty in robotic multilevel surgery.
Vicini C, Montevecchi F, Dallan I, Canzi P, Tenti G. Transoral robotic geniohyoidpexy as an additional step of transoral robotic tongue base reduction and supraglottoplasty: feasibility in a cadaver model. ORL J Otorhinolaryngol Relat Spec. 2011;73:147–50.
Lin HS, Rowley JA, Badr MS, Folbe AJ, Yoo GH, Victor L, Mathog RH, Chen W. Transoral robotic surgery for treatment of obstructive sleep apnea-hypopnea syndrome. Laryngoscope. 2013;123:1811–6.
•• Vicini C, Montevecchi F, Magnuson JS. Robotic Surgery for obstructive sleep apnea. Curr Otorhinolaryngol Rep. 2013;3:130–6. This article explained into details the robotic tongue base reduction technique.
• Glazer TA, Hoff PT, Spector ME. Transoral robotic surgery for obstructive sleep apnea: perioperative management and postoperative complications. JAMA Otolaryngol Head Neck Surg. 2014;140:1207–12. Interesting paper with a large number of revised cases: it underline the safety of TORS in terms of low number of not significant complications.
• Vicini C, Montevecchi F, Campanini A, Dallan I, Hoff PT, Spector ME, Thaler E, Ahn J, Baptista P, Remacle M, Lawson G, Benazzo M, Canzi P. Clinical outcomes and complications associated with TORS for OSAHS: a benchmark for evaluating an emerging surgical technology in a targeted application for benign disease. ORL J Otorhinolaryngol Relat Spec. 2014;76:63–9. This study is a multicentric study evaluating outcomes and complication in robotic multilevel surgery.
Toh ST, Han HJ, Tay HN, Kiong KL. Transoral robotic surgery for obstructive sleep apnea in Asian patients: a Singapore sleep centre experience. JAMA Otolaryngol Head Neck Surg. 2014;140:624–9.
Richmon JD, Feng AL, Yang W, Starmer H, Quon H, Gourin CG. Feasibility of rapid discharge after transoral robotic surgery of the oropharynx. Laryngoscope. 2014;124:2518–25.
Chiffer RC, Schwab RJ, Keenan BT, Borek RC, Thaler ER. Volumetric MRI analysis pre- and post-transoral robotic surgery for obstructive sleep apnea. Laryngoscope. 2015;125:1988–95.
Golbin D, Musgrave B, Succar E, Yaremchuk K. Clinical analysis of drug-induced sleep endoscopy for the OSA patient. Laryngoscope. 2015 [Epub ahead of print].
Crawford JA, Montevecchi F, Vicini C, Magnuson JS. Transoral robotic sleep surgery: the obstructive sleep apnea-hypopnea syndrome. Otolaryngol Clin N Am. 2014;47:397–406.
Hoff PT, Glazer TA, Spector ME. Body mass index predicts success in patients undergoing transoral robotic surgery for obstructive sleep apnea. ORL J Otorhinolaryngol Relat Spec. 2014;76:266–72.
Lin HS, Rowley JA, Folbe AJ, Yoo GH, Badr MS, Chen W. Transoral robotic surgery for treatment of obstructive sleep apnea: factors predicting surgical response. Laryngoscope. 2015;125:1013–20.
• Eesa M, Montevecchi F, Hendawy E, D’Agostino G, Meccariello G, Vicini C. Swallowing outcome after TORS for sleep apnea: short- and long-term evaluation. Eur Arch Otorhinolaryngol. 2015;272:1537–41. This study is one of the first evaluating the swallowing function after TORS for OSA.
Author information
Authors and Affiliations
Corresponding author
Additional information
This article is part of the Topical Collection on Sleep Apnea.
Rights and permissions
About this article
Cite this article
Vicini, C., Montevecchi, F., D’Agostino, G. et al. TORS for Obstructive Sleep Apnea–Hypopnea Syndrome. Curr Otorhinolaryngol Rep 4, 1–5 (2016). https://doi.org/10.1007/s40136-016-0110-8
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40136-016-0110-8