title: Combined transoral robotic tongue base surgery and palate surgery in obstructive sleep apnea-hypopnea syndrome: expansion sphincter pharyngoplasty versus uvulopalatopharyngoplasty.
abstract: BACKGROUND
  Transoral robotic surgery (TORS) for obstructive sleep apnea-hypopnea syndrome is a relatively young technique principally devised for managing apneas in the tongue base (TB) area and supraglottic larynx. This procedure is included in the so-called "multilevel surgery" often including a palatal and nasal surgery.
  
  
  METHODS
  We carried out a retrospective analysis in order to understand in detail the relative impact on apneas of the 2 different procedures carried out in the palate area (expansion sphincter pharyngoplasty and uvulopalatopharyngoplasty). We evaluated 2 groups, each of 12 cases, which were sorted according to the primary selection criteria of statistically comparable preoperative apnea-hypopnea index (AHI), sex, age, body mass index (BMI), and volume of removed TB tissue.
  
  
  RESULTS
  Postoperative AHI registered was of 9.9 ± 8.6 SD for the expansion sphincter pharyngoplasty group and 19.8 ± 14.1 SD for the uvulopalatopharyngoplasty group.
  
  
  CONCLUSIONS
  As the palate component of our multilevel procedure, expansion sphincter pharyngoplasty, including conventional nose surgery and robotic surgery, seems to be superior to uvulopalatopharyngoplasty.
authors.affiliation: Department of Special Surgery, ENT and Oral Surgery Unit, G.B. Morgagni - L. Pierantoni Hospital, University of Pavia in Forlì, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Vicini
authors.forename: Filippo
authors.initials: F
authors.lastname: Montevecchi
authors.forename: Kenny
authors.initials: K
authors.lastname: Pang
authors.forename: Ahmed
authors.initials: A
authors.lastname: Bahgat
authors.forename: Iacopo
authors.initials: I
authors.lastname: Dallan
authors.forename: Sabrina
authors.initials: S
authors.lastname: Frassineti
authors.forename: Aldo
authors.initials: A
authors.lastname: Campanini
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D019647:Oral Surgical Procedures / Q000379:methods; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D010614:Pharynx / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D012371:Robotics / Q000379:methods*; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000601:surgery*; D018709:Statistics, Nonparametric; D014059:Tongue / Q000601:surgery; D016896:Treatment Outcome; D014609:Uvula / Q000601:surgery*
keywords: obstructive sleep apnea hypopnea syndrome; palate surgery; robotic surgery; sleep apnea; tongue base