Randomized study comparing two tongue base surgeries for moderate to severe obstructive sleep apnea syndrome

Abstract

Objective: To compare the effectiveness and morbidity of the tongue base radiofrequency and tongue base suspension techniques combined with uvulopalatopharyngoplasty for moderate to severe obstructive sleep apnea. Study Design and Setting: Prospective and randomized surgical trial at a university hospital. Methods: In total, 57 patients received either tongue base radiofrequency reduction (n = 29) or tongue base suspension (n = 28). Apnea-hypopnea index, lowest oxygen saturation (polysomnography), Epworth score, and side effects were assessed. Success was defined as a ≥50 percent reduction and final apneahypopnea index < 15/h, and an Epworth score < 11. Results: The success rates of the two procedures were 57.1 percent and 51.7 percent, respectively ( P = 0.79), but only 12.5 percent and 10 percent, respectively ( P = 0.87), in obese patients. Body mass index ( P = 0.0002) was the main predictor of success in a logistic regression analysis. Tongue base suspension demonstrated higher morbidity ( P < 0.05). Conclusions: The effectiveness of tongue base suspension was similar to that of tongue base radiofrequency reduction, although with significantly higher morbidity, for moderate to severe obstructive sleep apnea. The effectiveness of both techniques was lower in obese patients. Significance: Neither technique should be used in obese patients who have moderate to severe obstructive sleep apnea.