Comparison of robotic and coblation tongue base resection for obstructive sleep apnea

Abstract

Objectives

To compare the efficacy and safety of transoral robotic surgery (TORS) with endoscope-guided coblation tongue base resection.

Design

Retrospective case-control study.

Setting

University-based tertiary care medical center.

Participants

OSA patients who underwent endoscope-guided tongue base coblation resection or TORS in combination with lateral pharyngoplasty at a single institution in South Korea between April 2013 and December 2016 were investigated. Forty-five patients who had moderate to severe OSA with tongue base collapse and a minimum follow-up period of 6 months with postoperative polysomnography (PSG) were enrolled in this study.

Main outcome measures

All patients underwent pre- and postoperative (at least 4 months after surgery) overnight PSG. Available information on results of the PSG, Epworth Sleepiness Scale, and complications of the TORS and coblation groups were compared.

Results

Postoperative PSG studies showed improved sleep quality for most patients. The mean postoperative apnea-hypopnea index (AHI) was reduced significantly from 45.0 to 17.0 events/h (p < 0.0001) in the TORS group and from 45.6 to 16.2 events/h (p < 0.0001) in the coblation group. The mean rates of improvement (AHI reduction > 50%) were 75.0% in TORS patients and 62.1% in coblation patients; the difference was not significant. Less frequent postoperative morbidity, including bleeding, taste dysfunction, and foreign body sensation, were recorded in TORS patients.

Conclusions

Both the coblation and TORS groups showed similar surgical outcomes, TORS achieved PSG results non-inferior to and complication rates comparable to coblation.

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