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79th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

30.04. - 04.05.2008, Bonn

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Tongue advancement – first results of a novel surgical treatment for retrolingual obstruction

Meeting Abstract

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  • corresponding author Boris A. Stuck - Department of Otorhinolaryngology, Head and Neck Surgery, Mannheim, Germany
  • author Evert Hamans - Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp, Belgium
  • author Alexander Baisch - Department of Otorhinolaryngology, Head and Neck Surgery, Mannheim, Germany
  • author Karl Hörmann - Department of Otorhinolaryngology, Head and Neck Surgery, Mannheim, Germany
  • author Joachim T. Maurer - Department of Otorhinolaryngology, Head and Neck Surgery, Mannheim, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 79th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Bonn, 30.04.-04.05.2008. Düsseldorf, Köln: German Medical Science; 2008. Doc08hno95

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hno2008/08hno95.shtml

Published: July 8, 2008

© 2008 Stuck et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Introduction: retrolingual obstruction in obstructive sleep apnoea is an unsolved issue in many ways, especially as the current surgical strategies are of limited efficacy or of significant morbidity. Aim of the study was to investigate a novel surgical approach in terms of titratable tongue advancement.

Methods: 22 patients with obstructive sleep apnoea (AHI>15, BMI<32) and isolated retrolingual obstruction were included in this prospective bicenter trial. A titanium tissue anchor was implanted into the tongue (Tongue Advancement, Aspire Medical) in general anaesthesia via a cervical approach and was fixed to a titratable spool at the mandible. After an adequate healing period, the tension on the system was modified at the spool under local anaesthesia if necessary. Postoperative pain was assessed with a patient diary (VAS 0-10). Before and 2 months after implantation three home sleep studies were performed and daytime sleepiness was assessed (ESS)

Results: Due to technical defects or malpositioning of the system the tissue anchor had to be removed in 4 out of 9 cases with the first and in 1 out of 13 cases with a modified system. Mild complications occurred in 5 out of 22 cases. Pain after implantation was moderate with a VAS of 4.3±2.7 (day 1) and 0.7±0.9 (day 5). Impairment of functional aspects did not occur. The AHI was reduced from 27.1±8.1 to 9.5±7.8 (n=14), the ESS improved from 12.7±5.4 to 6.9±5.5.

Conclusion: tongue advancement is an interesting alternative in the surgical treatment of obstructive sleep apnoea. Technical problems that appeared with the initial system were overcome with a modified device. Postoperative morbidity is limited, especially the ability for titration after implantation appears promising.