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272633

Endoscopic Assisted Coblation Lingual Tonsillectomy: Our Experience in Selected Cases with Obstructive Sleep Apnea

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Last updated: 22 Jan 2023

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Abstract

Abstract Background: Obstructive Sleep apnea (OSA) is a disorder characterized by frequent cessation of breathing (apnea) and or shallow breathing (hypopnea) during sleep. Multilevel obstructions, including both retropalatal and retrolingual obstructions, are usually identified in more than half of the OSA patients. Aim of Study: The importance of tongue base hypertrophy in OSA is now clear. Butsurgery remains challenging. This study aimed to report our results in the assessment of lingual tonsillectomy by coblation for the management of tongue base hypertrophy in patients with moderate to severe OSA. Patients and Methods: This prospective study was con-ducted between 2019 and 2021 on patients with moderate to severe OSA with retro-lingual collapse that was confirmed by awake and drug induced sleep endoscopy (DISE). Endo-scopic assisted coblation lingual tonsillectomy (EACLT) was performed for all patients in combination with other palatal and/or nasal surgeries. Preoperative and 3 to 6 months after surgery, all patients underwent polysomnography and Epworth Sleepiness Scale (ESS), and values were assessed. Results: Within the included 24 patients, the mean apnea hypopnea index (AHI) dropped significantly (p<0.001) from 46.87±15.86 preoperatively to 19.30±13.42 postoperatively. Successful outcome was reported in 16 patients (66.7%). The mean oxygen desaturation index (ODI) decreased from 43.41±  14/h to 19.93±13.7/h (p<0.001). The mean minimal oxygen saturation (SaO2) increased from 77.46±11.01% to 86.22±  9.46% (p<0.001). Two patients (8.3%) developed delayed postoperative bleeding from the tonsillar bed. Oth-erwise, no significant intra or postoperative complications were reported. No patients developed tongue oedema or required ICU admission. Conclusions: EACLTappears a safe and effective method for addressing lymphatic tongue base hypertrophy in patients with OSA with minimal side effects.

DOI

10.21608/mjcu.2022.272633

Keywords

coblation, Tongue base surgery, Obstructive sleep apnea, Lingual tonsillectomy

Authors

First Name

MOHAMED EESA, M.D.;

Last Name

MOHAMMAD W. EL-ANWAR, M.D.

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First Name

MOHAMED E. ELSHORA, M.D.;

Last Name

EHSAN HENDAWY, M.D.

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Affiliation

The Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Zagazig University

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Volume

90

Article Issue

9

Related Issue

37084

Issue Date

2022-09-01

Receive Date

2022-12-05

Publish Date

2022-09-01

Page Start

1,797

Page End

1,804

Print ISSN

0045-3803

Online ISSN

2536-9806

Link

https://mjcu.journals.ekb.eg/article_272633.html

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https://mjcu.journals.ekb.eg/service?article_code=272633

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272,633

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Original Article

Type Code

263

Publication Type

Journal

Publication Title

The Medical Journal of Cairo University

Publication Link

https://mjcu.journals.ekb.eg/

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Article

Created At

22 Jan 2023