title: Transoral robotic surgery of the tongue base in obstructive sleep Apnea-Hypopnea syndrome: anatomic considerations and clinical experience.
abstract: BACKGROUND
  The purpose of our work was to describe, through cadaveric dissection, the anatomy of the tongue base with a robotic perspective and to demonstrate the feasibility of this approach in case of tongue base hypertrophy in Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS).
  
  
  METHODS
  Forty-four patients with OSAHS underwent tongue base resection in the last 2 years. Twenty patients with a 10-month minimum follow-up were evaluated. The anatomic details of 3 tongue bases dissected from above are illustrated.
  
  
  RESULTS
  The cadaveric study shows that no constant landmarks are identifiable, with no significant neurovascular structures present in the midline. Clinically, transoral robotic surgery (TORS) for the tongue base was feasible, with no major complications and satisfaction of the majority of patients. Mean apnea hypopnea index (AHI) improvement was 24.6 ± 22.2 SD, mean Epworth Sleepiness Scale (ESS) improvement was 5.9 ± 4.4 SD.
  
  
  CONCLUSIONS
  Tongue base hypertrophy can be safely and effectively managed by TORS in OSAHS. Our midterm data are encouraging and worthy of further evaluation.
authors.affiliation: Department of Special Surgery, Ear, Nose, and Throat, and Oral Surgery Unit, Ospedale Morgagni Pierantoni, University of Pavia in Forlì, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Vicini
authors.forename: Iacopo
authors.initials: I
authors.lastname: Dallan
authors.forename: Pietro
authors.initials: P
authors.lastname: Canzi
authors.forename: Sabrina
authors.initials: S
authors.lastname: Frassineti
authors.forename: Andrea
authors.initials: A
authors.lastname: Nacci
authors.forename: Veronica
authors.initials: V
authors.lastname: Seccia
authors.forename: Erica
authors.initials: E
authors.lastname: Panicucci
authors.forename: Maria
authors.initials: M
authors.lastname: Grazia La Pietra
authors.forename: Filippo
authors.initials: F
authors.lastname: Montevecchi
authors.forename: Manfred
authors.initials: M
authors.lastname: Tschabitscher
mesh_terms: D000328:Adult; D000368:Aged; D002102:Cadaver; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D012371:Robotics / Q000379:methods*; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D014059:Tongue / Q000033:anatomy & histology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult