Randomized study comparing two tongue base surgeries for moderate to severe obstructive sleep apnea syndrome.
OBJECTIVE
To compare the effectiveness and morbidity of the tongue base radiofrequency and tongue base suspension techniques combined with uvulopalatopharyngoplasty for moderate to severe obstructive sleep apnea.


METHODS
Prospective and randomized surgical trial at a university hospital.


METHODS
In total, 57 patients received either tongue base radiofrequency reduction (n = 29) or tongue base suspension (n = 28). Apnea-hypopnea index, lowest oxygen saturation (polysomnography), Epworth score, and side effects were assessed. Success was defined as a > or =50 percent reduction and final apneahypopnea index < 15/h, and an Epworth score < 11.


RESULTS
The success rates of the two procedures were 57.1 percent and 51.7 percent, respectively (P = 0.79), but only 12.5 percent and 10 percent, respectively (P = 0.87), in obese patients. Body mass index (P = 0.0002) was the main predictor of success in a logistic regression analysis. Tongue base suspension demonstrated higher morbidity (P < 0.05).


CONCLUSIONS
The effectiveness of tongue base suspension was similar to that of tongue base radiofrequency reduction, although with significantly higher morbidity, for moderate to severe obstructive sleep apnea. The effectiveness of both techniques was lower in obese patients.


CONCLUSIONS
Neither technique should be used in obese patients who have moderate to severe obstructive sleep apnea.
Fernández-Julián
Enrique
E
Otorhinolaryngology Department, Hospital Clínico Universitario, University of Valencia, Valencia, Spain. fernandez_enr@gva.es
Muñoz
Noelia
N
Achiques
Maria Teresa
MT
García-Pérez
Miguel A
MA
Orts
Miguel
M
Marco
Jaime
J
D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000379:methods; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D017286:Polysomnography; D011446:Prospective Studies; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D014059:Tongue / Q000601:surgery*; D016896:Treatment Outcome