Transoral Tongue Suspension for Obstructive Sleep Apnea—A Preliminary Study
Objectives: To evaluate the safety and efficacy of a novel technique for transoral tongue suspension (TOTS) in obstructive sleep apnea (OSA) patients. Material and Methods: The retrospective study enrolled 24 consecutive OSA patients (21 males; average age, 43 years; average apnea–hypopnea index (AH...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/17/4960 |
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| author | Li-Jen Hsin Yi-Chan Lee Wan-Ni Lin Yi-An Lu Li-Ang Lee Ming-Shao Tsai Wen-Nuan Cheng Yen-Ting Chiang Hsueh-Yu Li |
| author_facet | Li-Jen Hsin Yi-Chan Lee Wan-Ni Lin Yi-An Lu Li-Ang Lee Ming-Shao Tsai Wen-Nuan Cheng Yen-Ting Chiang Hsueh-Yu Li |
| author_sort | Li-Jen Hsin |
| collection | DOAJ |
| description | Objectives: To evaluate the safety and efficacy of a novel technique for transoral tongue suspension (TOTS) in obstructive sleep apnea (OSA) patients. Material and Methods: The retrospective study enrolled 24 consecutive OSA patients (21 males; average age, 43 years; average apnea–hypopnea index (AHI), 42.2 event/h; average body mass index (BMI), 25.7 kg/m<sup>2</sup>) with tongue obstruction confirmed by drug-induced sleep endoscopy. All patients received TOTS as the main procedure in conjunction with uvulopalatopharyngoplasty (UPPP). Key procedures of TOTS included a transoral sublabial approach, drilling two holes on the mandible, passing the polypropylene through the hole to the tongue base using a suture passer and returning the polypropylene through loop traction, and tying the polypropylene to the mandible. Lingual tonsil ablation (<i>n</i> = 8) was also implemented in hypertrophic lingual tonsils (grades III and IV). Results: The operation time for TOTS was around 30 min. No wound bleeding or airway compromise occurred throughout the postoperative period. Minor complications were temporary and included swelling of the tongue, numbness of the lower incisor, and sublabial wound dehiscence (<i>n</i> = 2). The quality of life improved significantly in the patients’ subjective daytime sleepiness according to the Epworth Sleepiness Scale (11.4 ± 3.2 vs. 5.7 ± 1.6, <i>p</i> < 0.001). The objective parameters of OSA also improved significantly in the apnea/hypopnea index (42.2 ± 21.8 vs. 19.5 ± 16.2, <i>p</i> < 0.001), minimal oxygen saturation (77.1 ± 12.2 vs. 81.7 ± 8.1, <i>p</i> = 0.026), and snoring index (207 ± 141 vs. 101 ± 91, <i>p</i> = 0.03). Conclusions: The demonstrated TOTS showed its advantage in low morbidity with a scarless exterior and easy performance with free availability in treating adult OSA patients with tongue obstruction. TOTS combined with UPPP significantly improved AHI and daytime sleepiness. TOTS can be implemented with lingual tonsillectomy to achieve both stabilization of the tongue and widening of hypopharyngeal airway. |
| first_indexed | 2024-03-10T01:40:20Z |
| format | Article |
| id | doaj.art-5bd980e8cafb493a8c055b7e46f7d5ba |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T01:40:20Z |
| publishDate | 2022-08-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-5bd980e8cafb493a8c055b7e46f7d5ba2023-11-23T13:25:14ZengMDPI AGJournal of Clinical Medicine2077-03832022-08-011117496010.3390/jcm11174960Transoral Tongue Suspension for Obstructive Sleep Apnea—A Preliminary StudyLi-Jen Hsin0Yi-Chan Lee1Wan-Ni Lin2Yi-An Lu3Li-Ang Lee4Ming-Shao Tsai5Wen-Nuan Cheng6Yen-Ting Chiang7Hsueh-Yu Li8Departments of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan 33305, TaiwanCollege of Medicine, Chang Gung University, Taoyuan 33302, TaiwanDepartments of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan 33305, TaiwanDepartments of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan 33305, TaiwanDepartments of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan 33305, TaiwanCollege of Medicine, Chang Gung University, Taoyuan 33302, TaiwanDepartment of Sports Sciences, University of Taipei, Taipei 11153, TaiwanDepartments of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan 33305, TaiwanDepartments of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan 33305, TaiwanObjectives: To evaluate the safety and efficacy of a novel technique for transoral tongue suspension (TOTS) in obstructive sleep apnea (OSA) patients. Material and Methods: The retrospective study enrolled 24 consecutive OSA patients (21 males; average age, 43 years; average apnea–hypopnea index (AHI), 42.2 event/h; average body mass index (BMI), 25.7 kg/m<sup>2</sup>) with tongue obstruction confirmed by drug-induced sleep endoscopy. All patients received TOTS as the main procedure in conjunction with uvulopalatopharyngoplasty (UPPP). Key procedures of TOTS included a transoral sublabial approach, drilling two holes on the mandible, passing the polypropylene through the hole to the tongue base using a suture passer and returning the polypropylene through loop traction, and tying the polypropylene to the mandible. Lingual tonsil ablation (<i>n</i> = 8) was also implemented in hypertrophic lingual tonsils (grades III and IV). Results: The operation time for TOTS was around 30 min. No wound bleeding or airway compromise occurred throughout the postoperative period. Minor complications were temporary and included swelling of the tongue, numbness of the lower incisor, and sublabial wound dehiscence (<i>n</i> = 2). The quality of life improved significantly in the patients’ subjective daytime sleepiness according to the Epworth Sleepiness Scale (11.4 ± 3.2 vs. 5.7 ± 1.6, <i>p</i> < 0.001). The objective parameters of OSA also improved significantly in the apnea/hypopnea index (42.2 ± 21.8 vs. 19.5 ± 16.2, <i>p</i> < 0.001), minimal oxygen saturation (77.1 ± 12.2 vs. 81.7 ± 8.1, <i>p</i> = 0.026), and snoring index (207 ± 141 vs. 101 ± 91, <i>p</i> = 0.03). Conclusions: The demonstrated TOTS showed its advantage in low morbidity with a scarless exterior and easy performance with free availability in treating adult OSA patients with tongue obstruction. TOTS combined with UPPP significantly improved AHI and daytime sleepiness. TOTS can be implemented with lingual tonsillectomy to achieve both stabilization of the tongue and widening of hypopharyngeal airway.https://www.mdpi.com/2077-0383/11/17/4960transoral tongue suspensionobstructive sleep apneatongue base suspensionuvulopalatopharyngoplastysnoringdaytime sleepiness |
| spellingShingle | Li-Jen Hsin Yi-Chan Lee Wan-Ni Lin Yi-An Lu Li-Ang Lee Ming-Shao Tsai Wen-Nuan Cheng Yen-Ting Chiang Hsueh-Yu Li Transoral Tongue Suspension for Obstructive Sleep Apnea—A Preliminary Study Journal of Clinical Medicine transoral tongue suspension obstructive sleep apnea tongue base suspension uvulopalatopharyngoplasty snoring daytime sleepiness |
| title | Transoral Tongue Suspension for Obstructive Sleep Apnea—A Preliminary Study |
| title_full | Transoral Tongue Suspension for Obstructive Sleep Apnea—A Preliminary Study |
| title_fullStr | Transoral Tongue Suspension for Obstructive Sleep Apnea—A Preliminary Study |
| title_full_unstemmed | Transoral Tongue Suspension for Obstructive Sleep Apnea—A Preliminary Study |
| title_short | Transoral Tongue Suspension for Obstructive Sleep Apnea—A Preliminary Study |
| title_sort | transoral tongue suspension for obstructive sleep apnea a preliminary study |
| topic | transoral tongue suspension obstructive sleep apnea tongue base suspension uvulopalatopharyngoplasty snoring daytime sleepiness |
| url | https://www.mdpi.com/2077-0383/11/17/4960 |
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