title: Coblation endoscopic lingual lightening (CELL) for obstructive sleep apnea.
abstract: This study investigated the feasibility, safety and efficacy of Coblation endoscopic lingual lightening (CELL) surgery for obstructive sleep apnea (OSA). This study was a retrospective case series in a tertiary referral sleep center. Twenty-five adults with moderate to severe OSA and determined to have retropalatal and tongue base obstruction based on Friedman tongue position III and fiberoptic endoscopy underwent CELL in combination with modified uvulopalatopharyngoplasty, known as relocation pharyngoplasty. CELL involves transoral resection of tongue base muscle tissue and lingual tonsil using Coblation under endoscopic guidance. The mean operation time for CELL was 42.6 ± 13.7 min. Total blood loss for CELL plus relocation pharyngoplasty was <50 ml in all patients. Mean postoperative pain score (sum of total pain scores/sum of total hospitalization day, visual analog scale, 0-10) was 2.6 ± 0.6. Postoperative bleeding and taste disturbance extending beyond 3 months occurred in one patient (4 %) individually. No patients reported tongue weakness or speech dysfunction. Epworth sleepiness scale improved from 9.6 ± 4.9 to 7.5 ± 4.3 (p = 0.023). Apnea-hypopnea index decreased from 45.7 ± 21.7 to 12.8 ± 8.2 events/hour (p < 0.001) 6 months after surgery. The overall response rate was 80 %. CELL is feasible, safe and effective in treating tongue base obstruction in OSA patients who underwent simultaneous relocation pharyngoplasty.
authors.affiliation: Department of Otolaryngology, Sleep Center, Linkou-Chang Gung Memorial Hospital, School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan. hyli38@cgmh.org.tw.|Department of Sleep Medicine, Royal Infirmary Edinburgh, Edinburgh, UK. hyli38@cgmh.org.tw.
authors.forename: Hsueh-Yu
authors.initials: HY
authors.lastname: Li
authors.affiliation: Department of Otolaryngology, Sleep Center, Linkou-Chang Gung Memorial Hospital, School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Li-Ang
authors.initials: LA
authors.lastname: Lee
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Kezirian
mesh_terms: D000328:Adult; D000402:Airway Obstruction / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology; D017286:Polysomnography / Q000379:methods; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D013624:Taiwan; D014059:Tongue / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome
keywords: Coblation endoscopic lingual lightening; Obstructive sleep apnea; Tongue base obstruction; Uvulopalatopharyngoplasty