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Inicio Acta Otorrinolaringológica Española Safety of tongue base procedures for sleep apnoea in adults: A systematic review...
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Vol. 73. Issue 6.
Pages 384-393 (November - December 2022)
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Vol. 73. Issue 6.
Pages 384-393 (November - December 2022)
Review article
Safety of tongue base procedures for sleep apnoea in adults: A systematic review and metanalysis from the YO-IFOS study group
Seguridad de la cirugía de la base de la lengua para la apnea obstructiva del sueño en adultos. Revisión sistemática y metaanálisis del grupo de investigación YO-IFOS
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Christian Calvo-Henriquezb,
Corresponding author
, Borja Boronat-Catalaa,b, Irene Rivero-Fernándeza,c, Giovanni Cammarotoa,d,e, Badr Ibrahima,f, Jerome R. Lechiena,g, Gabriel Martínez-Capoccionia,b, Marina Carrasco-Llatash, Robson Capassof, Carlos Martin-Martinb
a Sleep Apnea Study Group of the Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Paris, France
b Service of Otolaryngology, Rhinology Department, Hospital Complex of Santiago de Compostela, Spain
c Service of Otolaryngology, Hospital 12 de Octubre, Madrid, Spain
d Department of Head-Neck Surgery, AUSL Romagna, Italy
e Ear Nose Throat (ENT) Unit of Forlì and Faenza, University of Ferrara and Bologna, Morgagni-Pierantoni Hospital, Forlì, Italy
f Department of Otolaryngology-Head and Neck Surgery, Sleep Medicine Division, Stanford Hospital and Clinics, Stanford, CA, USA
g 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
h Service of Otolaryngology. Hospital Universitario Dr. Peset, Valencia, Spain
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Abstract
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Abstract
Objective

Tongue 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 sources

PubMed (Medline), the Cochrane Library, EMBASE, Scopus, SciELO and Trip Database.

Review methods

Data 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.

Results

20 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.

Conclusion

The 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
Resumen
Objetivo

La base de la lengua y la hipofaringe son los principales sitios de obstrucción en pacientes con AOS persistente tras una faringoplastia. En los últimos años se han desarrollado numerosas técnicas de cirugía mínimamente invasiva con el objetivo de tratar la obstrucción en este nivel. Sin embargo, el foco de los investigadores se ha situado habitualmente en la efectividad de la técnica para reducir el número de eventos obstructivos, más que en sus complicaciones. En esta revisión sistemática y metaanálisis se evalúa la incidencia de complicaciones de procedimientos mínimamente invasivos para la base de la lengua en pacientes adultos con AOS.

Bases de datos

PubMed (Medline), Cochrane Library, EMBASE, Scopus, SciELO y Trip Database.

Método de revisión

Las bases de datos fueron evaluadas por 3 autores del grupo de investigación en apnea YO-IFOS. Tres autores extrajeron la información. Los resultados principales se expresaron como porcentaje de complicación e intervalo de confianza al 95% para cada técnica quirúrgica.

Resultados

Veinte estudios (542 pacientes) cumplieron los criterios de inclusión. La incidencia media de complicaciones fue del 12,79%; un 4,65% fueron menores, un 6,42% moderadas y un 1,77% severas. La complicación más habitual fue infección en el 1,95% de los casos, seguida por alteración transitoria de la deglución en un 1,30%.

Conclusión

La heterogeneidad de los artículos incluidos no permite obtener conclusiones firmes. La evidencia disponible muestra que la cirugía mínimamente invasiva de la base de la lengua presenta un intervalo amplio de complicaciones que varía entre el 4,4% en la radiofrecuencia de la base de la lengua y el 42,42% en la ablación de la base de la lengua.

Palabras clave:
Base de la lengua
AOS
Apnea
Radiofrecuencia de la base de la lengua
TORS
Suspensión lingual
SMILE

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