Gunawardena, Indunil, Robinson, Sam, MacKay, Stuart, Woods, Charmaine M., Choo, June, Esterman, Adrian, and Carney, A. Simon (2013) Submucosal lingualplasty for adult obstructive sleep apnea. Otolaryngology - Head And Neck Surgery, 148 (1). pp. 157-165.

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Abstract

Objective: To measure quality-of-life outcomes, polysomnographic outcomes, and adverse effects for a new technique of tongue reduction in obstructive sleep apnea.

Study Design: Case series.

Setting: Tertiary hospital.

Subjects and Methods: Consecutively treated adult patients (N = 27) with obstructive sleep apnea having submucosal lingualplasty in 2007 were studied. All had concurrent or previous uvulopalatoplasty +/- palatal advancement. Full polysomnography preoperatively and 3.7 +/- 0.4 months postoperatively, scored using the American Academy of Sleep Medicine 2007 criteria, was recorded. Snoring severity score, Epworth Sleepiness Scale, and complication data were collected at a 2.61 +/- 0.08-year follow-up via questionnaire.

Results: Mean snoring severity score fell from 7.1 +/- 0.4 to 2.3 +/- 0.6 (P < .05). Epworth Sleepiness Scale score fell from 8.3 +/- 1.1 to 5.8 +/- 1.0 (P < .05). The apnea-hypopnea index (AHI) fell from 44.0 +/- 4.3 to 12.5 +/- 2.3 (P < .05). Success, defined as achieving an AHI <15 postoperatively, was observed in 74% (20/27), with each of these patients achieving a reduction in AHI >50%. Lowest oxygen saturation improved from 84 +/- 1 to 88 +/- 1 (P < .05). Pain was mild to moderate. Short-term postoperative complications included bleeding (3.7%) and infection (14.8%). Some minor long-term (6 months) alteration in tongue function was reported with regard to speech (47%), swallow (33%), and taste (33%).

Conclusion: Submucosal lingualplasty with concurrent palatal surgery is a promising treatment option in adult patients with obstructive sleep apnea with macroglossia.

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