Our Summary

Obstructive Sleep Apnoea-Hypopnoea (OSAH) is a significant health issue that is becoming more common. One of the main treatments, continuous positive airway pressure, is often not used correctly by patients. This has led to a renewed interest in surgical treatments. To decide on the best surgical approach, doctors need to accurately identify where the airway is collapsing. They typically use drug-induced sleep testing and medical imaging to do this, often finding that the base of the tongue and the epiglottis (a flap that covers the windpipe while swallowing) are the main areas causing problems.

A new surgical technique, Transoral Robotic Surgery (TORS), has been successfully used to adjust these areas. The surgery is safe and well tolerated by patients when performed by experienced surgeons. Careful selection of patients and thorough preparation are important factors for success.

Short-term results from multiple studies show that TORS significantly reduces sleep apnea symptoms and daytime sleepiness. If more hospitals gain access to robotic surgical technology and the necessary training, these positive results could potentially benefit more patients. However, longer-term studies are still needed to definitively determine how effective TORS is in treating sleep apnea.

FAQs

  1. What is Transoral Robotic Surgery (TORS) and how is it used to treat Obstructive Sleep Apnoea-Hypopnoea (OSAH)?
  2. What are the preliminary results of using TORS for treating sleep apnea symptoms and daytime sleepiness?
  3. Why is careful patient selection and preparation important for the success of TORS in treating OSAH?

Doctor’s Tip

One tip a doctor might give a patient about robotic surgery for sleep apnea is to follow post-operative care instructions carefully to ensure a successful outcome. This may include avoiding certain foods or activities, taking prescribed medications as directed, and attending follow-up appointments. It is also important to communicate any concerns or changes in symptoms to your healthcare provider promptly. By following these recommendations, patients can optimize their recovery and potentially improve their quality of life.

Suitable For

Patients who are typically recommended for robotic surgery for obstructive sleep apnea include those who have not responded well to other treatments such as CPAP therapy, have specific areas of airway collapse that can be addressed with TORS, and are in overall good health for surgery. Patients with severe sleep apnea, significant daytime sleepiness, and other related health issues may also be good candidates for robotic surgery. It is important for patients to discuss their individual situation with their healthcare provider to determine if TORS is the best treatment option for them.

Timeline

Before robotic surgery:

  • Patient is diagnosed with obstructive sleep apnoea-hypopnoea (OSAH) through symptoms and testing
  • Patient undergoes drug-induced sleep testing and medical imaging to identify specific areas of airway collapse
  • Doctors determine that the base of the tongue and epiglottis are causing issues
  • Patient is selected as a candidate for Transoral Robotic Surgery (TORS) after careful evaluation and preparation

After robotic surgery:

  • Patient undergoes TORS procedure to adjust the base of the tongue and epiglottis
  • Surgery is safe and well tolerated by the patient
  • Short-term results show significant reduction in sleep apnea symptoms and daytime sleepiness
  • Patient may experience improved quality of life and better sleep after surgery
  • Long-term studies are needed to determine the effectiveness of TORS in treating sleep apnea in the future.

What to Ask Your Doctor

  1. What is Transoral Robotic Surgery (TORS) and how does it differ from traditional surgical approaches for treating sleep apnea?

  2. Am I a suitable candidate for TORS? What criteria do you use to determine if a patient is a good candidate for this surgery?

  3. What are the potential risks and complications associated with TORS for treating sleep apnea?

  4. What is the expected recovery time after TORS surgery? Will I need to stay in the hospital overnight?

  5. How successful is TORS in reducing sleep apnea symptoms and improving daytime sleepiness in the short term?

  6. Are there any long-term studies on the effectiveness of TORS for treating sleep apnea? What are the potential long-term outcomes of this surgery?

  7. Will I need any additional treatments or therapies after TORS surgery to manage my sleep apnea?

  8. How many TORS procedures have you performed for sleep apnea, and what is your success rate with this surgery?

  9. Are there any lifestyle changes or modifications I should make before or after TORS surgery to improve the outcomes?

  10. Are there any alternative surgical treatments for sleep apnea that I should consider, and how do they compare to TORS in terms of safety and effectiveness?

Reference

Authors: Vauterin T, Garas G, Arora A. Journal: ORL J Otorhinolaryngol Relat Spec. 2018;80(3-4):134-147. doi: 10.1159/000489465. Epub 2018 Jun 22. PMID: 29936512