Predictors of success in combination of tongue base resection and lateral pharyngoplasty for obstructive sleep apnea

Chi Sang Hwang, Jin Won Kim, Sang Chul Park, Hyo Jin Chung, Chang-Hoon Kim, Joo Heon Yoon, Hyung Ju Cho

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

The base of the tongue has been recognized as a significant site of obstruction in patients with obstructive sleep apnea (OSA). Our aim was to determine the independent predictors of surgical success in tongue base resection combined with lateral pharyngoplasty for OSA. Thirty-one OSA patients who underwent endoscopie-guided coblator or transoral robotic tongue base resection in combination with lateral pharyngoplasty for the treatment of retroglossal obstruction between March 2012 and December 2015 were enrolled in this study. Retroglossal obstruction was identified by preoperative nasopharyngoscopy with drug-induced sleep endoscopy and/or Müller’s maneuver in supine position. Patients were divided into success and failure groups according to surgical outcome (postoperative apnea–hypopnea index (AHI) less than 20 and reduction more than 50% in baseline AHI). Physical profile, polysomnography, cephalometry parameters, and drug-induced sleep endoscopy and/or Müller’s maneuver findings were compared between the two groups. Tonsil grade (p = 0.002), lateral oropharyngeal wall collapse on Müller’s maneuver (p = 0.002), and AHI during rapid eye movement (REM AHI) (p = 0.038) were significantly higher in the success group than in the failure group. Tongue base collapse was more evident in the failure group than in the success group when patients open their mouth. (p = 0.037) Bigger tonsil size and higher REM AHI are favorable predictive factors, even in multilevel surgery such as tongue base resection, whereas tongue base collapse during mouth opening may be an unfavorable predictive factor.

Original languageEnglish
Pages (from-to)2197-2203
Number of pages7
JournalEuropean Archives of Oto-Rhino-Laryngology
Volume274
Issue number5
DOIs
Publication statusPublished - 2017 May 1

Fingerprint

Obstructive Sleep Apnea
Tongue
Palatine Tonsil
Endoscopy
Mouth
Sleep
Cephalometry
Polysomnography
Supine Position
REM Sleep
Robotics
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Otorhinolaryngology

Cite this

Hwang, Chi Sang ; Kim, Jin Won ; Park, Sang Chul ; Chung, Hyo Jin ; Kim, Chang-Hoon ; Yoon, Joo Heon ; Cho, Hyung Ju. / Predictors of success in combination of tongue base resection and lateral pharyngoplasty for obstructive sleep apnea. In: European Archives of Oto-Rhino-Laryngology. 2017 ; Vol. 274, No. 5. pp. 2197-2203.
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abstract = "The base of the tongue has been recognized as a significant site of obstruction in patients with obstructive sleep apnea (OSA). Our aim was to determine the independent predictors of surgical success in tongue base resection combined with lateral pharyngoplasty for OSA. Thirty-one OSA patients who underwent endoscopie-guided coblator or transoral robotic tongue base resection in combination with lateral pharyngoplasty for the treatment of retroglossal obstruction between March 2012 and December 2015 were enrolled in this study. Retroglossal obstruction was identified by preoperative nasopharyngoscopy with drug-induced sleep endoscopy and/or M{\"u}ller’s maneuver in supine position. Patients were divided into success and failure groups according to surgical outcome (postoperative apnea–hypopnea index (AHI) less than 20 and reduction more than 50{\%} in baseline AHI). Physical profile, polysomnography, cephalometry parameters, and drug-induced sleep endoscopy and/or M{\"u}ller’s maneuver findings were compared between the two groups. Tonsil grade (p = 0.002), lateral oropharyngeal wall collapse on M{\"u}ller’s maneuver (p = 0.002), and AHI during rapid eye movement (REM AHI) (p = 0.038) were significantly higher in the success group than in the failure group. Tongue base collapse was more evident in the failure group than in the success group when patients open their mouth. (p = 0.037) Bigger tonsil size and higher REM AHI are favorable predictive factors, even in multilevel surgery such as tongue base resection, whereas tongue base collapse during mouth opening may be an unfavorable predictive factor.",
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Predictors of success in combination of tongue base resection and lateral pharyngoplasty for obstructive sleep apnea. / Hwang, Chi Sang; Kim, Jin Won; Park, Sang Chul; Chung, Hyo Jin; Kim, Chang-Hoon; Yoon, Joo Heon; Cho, Hyung Ju.

In: European Archives of Oto-Rhino-Laryngology, Vol. 274, No. 5, 01.05.2017, p. 2197-2203.

Research output: Contribution to journalArticle

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AU - Kim, Jin Won

AU - Park, Sang Chul

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AB - The base of the tongue has been recognized as a significant site of obstruction in patients with obstructive sleep apnea (OSA). Our aim was to determine the independent predictors of surgical success in tongue base resection combined with lateral pharyngoplasty for OSA. Thirty-one OSA patients who underwent endoscopie-guided coblator or transoral robotic tongue base resection in combination with lateral pharyngoplasty for the treatment of retroglossal obstruction between March 2012 and December 2015 were enrolled in this study. Retroglossal obstruction was identified by preoperative nasopharyngoscopy with drug-induced sleep endoscopy and/or Müller’s maneuver in supine position. Patients were divided into success and failure groups according to surgical outcome (postoperative apnea–hypopnea index (AHI) less than 20 and reduction more than 50% in baseline AHI). Physical profile, polysomnography, cephalometry parameters, and drug-induced sleep endoscopy and/or Müller’s maneuver findings were compared between the two groups. Tonsil grade (p = 0.002), lateral oropharyngeal wall collapse on Müller’s maneuver (p = 0.002), and AHI during rapid eye movement (REM AHI) (p = 0.038) were significantly higher in the success group than in the failure group. Tongue base collapse was more evident in the failure group than in the success group when patients open their mouth. (p = 0.037) Bigger tonsil size and higher REM AHI are favorable predictive factors, even in multilevel surgery such as tongue base resection, whereas tongue base collapse during mouth opening may be an unfavorable predictive factor.

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