Effectiveness of transoral robotic tongue base surgery in patients with obstructive sleep Apnoea.

purposeTo evaluate the feasibility, morbidity, and efficacy of transoral robotic surgery (TORS) tongue base resection (TBR) combined with upper airway airflow-facilitating surgeries in patients with obstructive sleep apnoea (OSA) characterized by tongue base hypertrophy and collapse, and to identify anatomical and nonanatomical predictors of surgical success.

methodsThis single-center, prospective observational cohort study included 110 adult patients with moderate to severe OSA (AHI ≥ 15) or positional OSA, who failed or refused conservative therapies. Retrolingual/hypopharyngeal obstruction and tongue base collapse were confirmed via drug-induced sleep endoscopy or flexible nasopharyngoscopy. Patients with contraindications for surgery, inadequate mouth opening, absence of postoperative polysomnography, or under 18 years of age were excluded. Demographic, polysomnographic, and perioperative data were collected and statistically analyzed.

resultsThe mean patient age was 47.4 ± 10.8 years, and mean BMI was 30.2 ± 4.0 kg/m²; 93.6% were male. All patients underwent TORS-TBR without the need for tracheostomy. The mean hospitalization period was 8.5 ± 4.3 days. Statistically significant differences between surgical success and failure groups included AHIREM, obstructive apnoea counts in REM and NREM, mean obstructive apnoea duration, total apnoea duration, lowest oxygen saturation, mean desaturation percentages, and sleep time with oxygen saturation below 90% (ST

conclusionTransoral robotic tongue base surgery, combined with individualized multilevel airway interventions, provides an effective, feasible early treatment option for OSA. This approach supports personalized management strategies and significantly improves polysomnographic outcomes, contributing to the reduction of OSA-related morbidity and mortality.