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Safety of tongue base procedures for sleep apnoea in adults: A systematic review and metanalysis from the YO-IFOS study group
Affiliation:1. Sleep Apnea Study Group of the Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Paris, France;2. Service of Otolaryngology, Rhinology Department, Hospital Complex of Santiago de Compostela, Spain;3. Service of Otolaryngology, Hospital 12 de Octubre, Madrid, Spain;4. Department of Head-Neck Surgery, AUSL Romagna, Italy;5. Ear Nose Throat (ENT) Unit of Forlì and Faenza, University of Ferrara and Bologna, Morgagni-Pierantoni Hospital, Forlì, Italy;6. Department of Otolaryngology-Head and Neck Surgery, Sleep Medicine Division, Stanford Hospital and Clinics, Stanford, CA, USA;7. Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France;8. Service of Otolaryngology. Hospital Universitario Dr. Peset, Valencia, Spain
Abstract:ObjectiveTongue base and hypopharynx are the major sites of obstruction in OSA patients with failed palatal surgery. In recent years, several minimally invasive procedures have been developed to address tongue base obstruction. However, the research focus has consistently been on the effectiveness of surgery in reducing obstructive sleep apnoea rather than on postoperative complications. In this systematic review and metanalysis we aim to review the complication rate of minimally invasive base of tongue procedures for OSAS in adults.Data sourcesPubMed (Medline), the Cochrane Library, EMBASE, Scopus, SciELO and Trip Database.Review methodsData sources were checked by three authors of the YO-IFOS sleep apnoea study group. Three authors extracted the data. Main outcome was expressed as the complication rate and 95% confidence interval for each surgical technique.Results20 studies (542 patients) met the inclusion criteria. The mean complication rate is 12.79%; 4.65% for minor complications, 6.42% if they are moderate, and 1.77% if severe. The most reported complication overall is infection, in 1.95% of cases, followed by transient swallowing disorder, occurring in 1.30% of the total sample.ConclusionThe heterogeneity amongst the included studies prevents us from obtaining solid conclusions. The available evidence suggests that minimally invasive base of tongue procedures may present a wide spectrum of complication rates, ranging from 4.4% in tongue base radiofrequency to up to 42.42% in tongue base ablation.
Keywords:Tongue base  OSA  Apnoea  Tongue base radiofrequency  TORS  Lingual suspension  SMILE  Base de la lengua  AOS  Apnea  Radiofrecuencia de la base de la lengua  TORS  Suspensión lingual  SMILE
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