title: Transoral robotic surgery for the management of obstructive sleep apnea: a systematic review and meta-analysis.
abstract: Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a serious social health problem with significant implications on quality of life. Surgery for OSAHS has been criticized due to a lack of evidence to support its efficacy as well as the heterogeneous reporting of published outcomes. Moreover, the transoral robotic surgery (TORS) in the management of OSAHS is still in a relative infancy. Nevertheless, a review and meta-analysis of the published articles may be helpful. Among 195 articles, eight studies were included in the analysis. The mean of enrolled patients was 102.5 ± 107.9 (range 6-289) comprising a total of 820 cases. The mean age was 49 ± 3.27 and 285 patients underwent a previous sleep apnea surgery. The uvulopalatopharyngoplasty (UPPP) was the most common palatal procedure. The mean rate of failure was 34.4 % (29.5-46.2 %). Complications occurred in 21.3 % of the patients included in the analysis, most of them were classified as minor. Transient dysphagia represented the most common complication (7.2 %) followed by bleeding (4.2 %). TORS for the treatment of OSAHS appears to be a promising and safe procedure for selected patients seeking an alternative to continuous positive airway pressure (CPAP), although further researches are urgently needed.
authors.affiliation: Otolaryngology and Stomatology Unit, Department of Head-Neck Surgeries, G.B. Morgagni-L.Pierantoni Hospital, Azienda USL della Romagna, via Carlo Forlanini, 34, Forlì, Italy. drmeccariello@gmail.com.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Meccariello
authors.affiliation: Department of Otorhinolaryngology, University of Messina, Messina, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cammaroto
authors.affiliation: Otolaryngology and Stomatology Unit, Department of Head-Neck Surgeries, G.B. Morgagni-L.Pierantoni Hospital, Azienda USL della Romagna, via Carlo Forlanini, 34, Forlì, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Montevecchi
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, St Joseph Mercy Health System, Ann Arbor, MI, USA.
authors.forename: Paut T
authors.initials: PT
authors.lastname: Hoff
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, Ann Arbor, MI, USA.
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Spector
authors.affiliation: Department of Otolaryngology, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Hesham
authors.initials: H
authors.lastname: Negm
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Medhat
authors.initials: M
authors.lastname: Shams
authors.affiliation: Otolaryngology and Stomatology Unit, Department of Head-Neck Surgeries, G.B. Morgagni-L.Pierantoni Hospital, Azienda USL della Romagna, via Carlo Forlanini, 34, Forlì, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Bellini
authors.affiliation: Otolaryngology and Stomatology Unit, Department of Head-Neck Surgeries, G.B. Morgagni-L.Pierantoni Hospital, Azienda USL della Romagna, via Carlo Forlanini, 34, Forlì, Italy.
authors.forename: Ermelinda
authors.initials: E
authors.lastname: Zeccardo
authors.affiliation: Otolaryngology and Stomatology Unit, Department of Head-Neck Surgeries, G.B. Morgagni-L.Pierantoni Hospital, Azienda USL della Romagna, via Carlo Forlanini, 34, Forlì, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Vicini
mesh_terms: D006801:Humans; D019647:Oral Surgical Procedures / Q000379:methods*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D065287:Robotic Surgical Procedures / Q000379:methods*; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D016896:Treatment Outcome
keywords: Base of tongue; Complication; Outcome; Robot; Sleep apnea; Transoral