Comparison of transoral robotic surgery with other surgeries for obstructive sleep apnea

This study compared the characteristic surgical parameters and clinical effects of transoral robotic surgery (TORS) and other available methods used to alleviate obstructive sleep apnea. Articles on TORS and other surgeries for obstructive sleep apnea were identified in the PubMed and EMBASE databases. Two investigators independently reviewed the articles and classified the data for meta-analysis. The pooled effect sizes of TORS (standardized mean difference; SMD=-2.38), coblation tongue base resection (CTBR; SMD=-2.00) and upper airway stimulation (UAS; SMD=-0.94) revealed significant improvement in the apnea-hypopnea index (AHI; p<0.05). The lowest O-2 saturation reported was significantly increased following TORS (SMD=1.43), CTBR (SMD=0.86) and UAS (SMD=1.24, p<0.05). Furthermore, TORS (SMD=-2.91) and CTBR (SMD=-1.51, p<0.05) significantly reduced the Epworth Sleepiness Scale (ESS) score. No significant difference in operation time, success rate, or instances of complication were observed between TORS and the other compared interventions. The use of TORS in obstructive sleep apnea has the same rate of success and failure as other methods of surgical intervention for obstructive sleep apnea with no statistical difference in operation times. The reported clinical effects on the AHI, lowest O-2 saturation, and ESS scores of TORS were similar to those of other surgeries.