Transoral robotic surgery of the tongue base in obstructive sleep Apnea-Hypopnea syndrome: anatomic considerations and clinical experience.

Background. The purpose of our work was to describe, through cadaveric dissection, the anatomy of the tongue base with a robotic perspective and to demonstrate the feasibility of this approach in case of tongue base hypertrophy in Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS). Methods. Forty-four patients with OSAHS underwent tongue base resection in the last 2 years. Twenty patients with a 10-month minimum follow-up were evaluated. The anatomic details of 3 tongue bases dissected from above are illustrated. Results. The cadaveric study shows that no constant landmarks are identifiable, with no significant neurovascular structures present in the midline. Clinically, transoral robotic surgery (TORS) for the tongue base was feasible, with no major complications and satisfaction of the majority of patients. Mean apnea hypopnea index (AHI) improvement was 24.6 +/- 22.2 SD, mean Epworth Sleepiness Scale (ESS) improvement was 5.9 +/- 4.4 SD. Conclusion. Tongue base hypertrophy can be safely and effectively managed by TORS in OSAHS. Our midterm data are encouraging and worthy of further evaluation. (C) 2011 Wiley Periodicals, Inc. Head Neck 34: 15-22, 2012