title: Submucosal lingualplasty for adult obstructive sleep apnea.
abstract: OBJECTIVE
  To measure quality-of-life outcomes, polysomnographic outcomes, and adverse effects for a new technique of tongue reduction in obstructive sleep apnea.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Tertiary hospital.
  
  
  METHODS
  Consecutively treated adult patients (N = 27) with obstructive sleep apnea having submucosal lingualplasty in 2007 were studied. All had concurrent or previous uvulopalatoplasty ± palatal advancement. Full polysomnography preoperatively and 3.7 ± 0.4 months postoperatively, scored using the American Academy of Sleep Medicine 2007 criteria, was recorded. Snoring severity score, Epworth Sleepiness Scale, and complication data were collected at a 2.61 ± 0.08-year follow-up via questionnaire.
  
  
  RESULTS
  Mean snoring severity score fell from 7.1 ± 0.4 to 2.3 ± 0.6 (P < .05). Epworth Sleepiness Scale score fell from 8.3 ± 1.1 to 5.8 ± 1.0 (P < .05). The apnea-hypopnea index (AHI) fell from 44.0 ± 4.3 to 12.5 ± 2.3 (P < .05). Success, defined as achieving an AHI <15 postoperatively, was observed in 74% (20/27), with each of these patients achieving a reduction in AHI >50%. Lowest oxygen saturation improved from 84 ± 1 to 88 ± 1 (P < .05). Pain was mild to moderate. Short-term postoperative complications included bleeding (3.7%) and infection (14.8%). Some minor long-term (6 months) alteration in tongue function was reported with regard to speech (47%), swallow (33%), and taste (33%).
  
  
  CONCLUSIONS
  Submucosal lingualplasty with concurrent palatal surgery is a promising treatment option in adult patients with obstructive sleep apnea with macroglossia.
authors.affiliation: Flinders ENT, Department of Surgery, Flinders Medical Centre and Flinders University, South Australia, Australia. indunilg@hotmail.com
authors.forename: Indunil
authors.initials: I
authors.lastname: Gunawardena
authors.forename: Sam
authors.initials: S
authors.lastname: Robinson
authors.forename: Stuart
authors.initials: S
authors.lastname: MacKay
authors.forename: Charmaine M
authors.initials: CM
authors.lastname: Woods
authors.forename: June
authors.initials: J
authors.lastname: Choo
authors.forename: Adrian
authors.initials: A
authors.lastname: Esterman
authors.forename: A Simon
authors.initials: AS
authors.lastname: Carney
mesh_terms: D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005927:Glossectomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009061:Mouth Mucosa / Q000601:surgery; D010160:Palate, Soft / Q000601:surgery*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D017286:Polysomnography / Q000379:methods; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000503:physiopathology / Q000628:therapy; D019106:Postoperative Hemorrhage / Q000503:physiopathology / Q000628:therapy; D018570:Risk Assessment; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000601:surgery*; D018709:Statistics, Nonparametric; D013536:Suture Techniques; D062606:Tertiary Care Centers; D014057:Tomography, X-Ray Computed / Q000379:methods; D014059:Tongue / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome