Transoral Robotic Surgery for Patients with Obstructive Sleep Apnoea: A Systematic Literature Review of Current Practices

Transoral robotic surgery (TORS) for tongue base reduction (TBR) and/or epiglottic surgery is an effective treatment option for selected patients with moderate to severe obstructive sleep apnoea (OSA). This systematic review aims to provide an up-to-date overview of current practices and challenges...

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Main Authors: Stavroula Mouratidou, Konstantinos Chaidas
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Life
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Online Access:https://www.mdpi.com/2075-1729/14/12/1700
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author Stavroula Mouratidou
Konstantinos Chaidas
author_facet Stavroula Mouratidou
Konstantinos Chaidas
author_sort Stavroula Mouratidou
collection DOAJ
description Transoral robotic surgery (TORS) for tongue base reduction (TBR) and/or epiglottic surgery is an effective treatment option for selected patients with moderate to severe obstructive sleep apnoea (OSA). This systematic review aims to provide an up-to-date overview of current practices and challenges associated with TORS for OSA. PubMed and Embase databases were searched up to December 2022 following PRISMA guidelines. Primary outcome measures were surgical technique, intraoperative measures, postoperative management and complications. A total of 32 articles, including 2546 patients, met the inclusion criteria. TORS was most commonly performed as part of a multilevel surgical approach. Nasotracheal intubation was the preferred method for general anaesthesia. The surgical technique for TORS tongue base and epiglottis did not differ significantly among institutions, although some variations exist. Postoperative management varied, with most authors aiming for immediate postoperative extubation, routine postoperative ward admission and early oral intake initiation. Common postoperative complications were dysphagia and bleeding, with no reported mortality. TORS is established as a safe and feasible surgical option for selected OSA patients, addressing tongue base and/or epiglottic obstruction. However, further studies are required to determine patients’ selection criteria, preferred volume of excised tongue tissue and to assess the necessity for postoperative intensive care unit monitoring.
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spelling doaj-art-d7448234a7214f6ea5b41b122fbc85242025-08-20T02:53:37ZengMDPI AGLife2075-17292024-12-011412170010.3390/life14121700Transoral Robotic Surgery for Patients with Obstructive Sleep Apnoea: A Systematic Literature Review of Current PracticesStavroula Mouratidou0Konstantinos Chaidas1ENT Department, Guys’ and St Thomas’ NHS Foundation Trust, London SE1 9RT, UKENT Department, University Hospital of Alexandroupolis, Democritus University of Thrace—Medical School, 68100 Alexandroupolis, GreeceTransoral robotic surgery (TORS) for tongue base reduction (TBR) and/or epiglottic surgery is an effective treatment option for selected patients with moderate to severe obstructive sleep apnoea (OSA). This systematic review aims to provide an up-to-date overview of current practices and challenges associated with TORS for OSA. PubMed and Embase databases were searched up to December 2022 following PRISMA guidelines. Primary outcome measures were surgical technique, intraoperative measures, postoperative management and complications. A total of 32 articles, including 2546 patients, met the inclusion criteria. TORS was most commonly performed as part of a multilevel surgical approach. Nasotracheal intubation was the preferred method for general anaesthesia. The surgical technique for TORS tongue base and epiglottis did not differ significantly among institutions, although some variations exist. Postoperative management varied, with most authors aiming for immediate postoperative extubation, routine postoperative ward admission and early oral intake initiation. Common postoperative complications were dysphagia and bleeding, with no reported mortality. TORS is established as a safe and feasible surgical option for selected OSA patients, addressing tongue base and/or epiglottic obstruction. However, further studies are required to determine patients’ selection criteria, preferred volume of excised tongue tissue and to assess the necessity for postoperative intensive care unit monitoring.https://www.mdpi.com/2075-1729/14/12/1700transoral robotic surgerytongue base reductionlingual tonsillectomyepiglottic surgeryobstructive sleep apnoea
spellingShingle Stavroula Mouratidou
Konstantinos Chaidas
Transoral Robotic Surgery for Patients with Obstructive Sleep Apnoea: A Systematic Literature Review of Current Practices
Life
transoral robotic surgery
tongue base reduction
lingual tonsillectomy
epiglottic surgery
obstructive sleep apnoea
title Transoral Robotic Surgery for Patients with Obstructive Sleep Apnoea: A Systematic Literature Review of Current Practices
title_full Transoral Robotic Surgery for Patients with Obstructive Sleep Apnoea: A Systematic Literature Review of Current Practices
title_fullStr Transoral Robotic Surgery for Patients with Obstructive Sleep Apnoea: A Systematic Literature Review of Current Practices
title_full_unstemmed Transoral Robotic Surgery for Patients with Obstructive Sleep Apnoea: A Systematic Literature Review of Current Practices
title_short Transoral Robotic Surgery for Patients with Obstructive Sleep Apnoea: A Systematic Literature Review of Current Practices
title_sort transoral robotic surgery for patients with obstructive sleep apnoea a systematic literature review of current practices
topic transoral robotic surgery
tongue base reduction
lingual tonsillectomy
epiglottic surgery
obstructive sleep apnoea
url https://www.mdpi.com/2075-1729/14/12/1700
work_keys_str_mv AT stavroulamouratidou transoralroboticsurgeryforpatientswithobstructivesleepapnoeaasystematicliteraturereviewofcurrentpractices
AT konstantinoschaidas transoralroboticsurgeryforpatientswithobstructivesleepapnoeaasystematicliteraturereviewofcurrentpractices