Minimally invasive, single‐stage, multilevel surgery for obstructive sleep apnoea: A systematic review and meta‐analysis

Author:

Rahavi‐Ezabadi Sara1,Su Yan‐Ye23,Wang Yu‐Han4,Lin Chung‐Wei25,Chang Chun‐Tuan6,Friedman Michael78,Salapatas Anna M.8,Amali Amin9,Lin Hsin‐Ching23610ORCID

Affiliation:

1. Otorhinolaryngology Research Center, Otorhinolaryngology Head and Neck Surgery Department Children's Medical Center, Tehran University of Medical Sciences Tehran Iran

2. Department of Otolaryngology Kaohsiung Chang Gung Memorial Hospital Kaohsiung Taiwan

3. Sleep Center and Robotic Surgery Center Kaohsiung Chang Gung Memorial Hospital Kaohsiung Taiwan

4. School of Medicine, College of Medicine Kaohsiung Medical University Kaohsiung Taiwan

5. Department of Education Kaohsiung Chang Gung Memorial Hospital Kaohsiung Taiwan

6. Department of Business Management, Institute of Healthcare Management, Institute of Biomedical Sciences National Sun Yat‐sen University Kaohsiung Taiwan

7. Department of Otolaryngology, Division of Sleep Surgery Rush University Medical Center Chicago Illinois USA

8. Department of Otolaryngology, Advanced Center for Specialty Care Advocate Illinois Masonic Medical Center Chicago Illinois USA

9. Sleep Breathing Disorders Research Center (SBDRC), Occupational Sleep Research Center (OSRC), Otorhinolaryngology Research Center, Otorhinolaryngology Head and Neck Surgery Department Tehran University of Medical Sciences Tehran Iran

10. Center for Quality Management Kaohsiung Chang Gung Memorial Hospital Kaohsiung; College of Medicine, Chang Gung University Taoyuan Taiwan

Abstract

AbstractObjectivesMinimally invasive, single‐staged multilevel surgery (MISS MLS) could be an optimal treatment for selected patients with obstructive sleep apnea (OSA). We aim to systematically review the efficacy of MISS MLS for patients with OSA, as well as the clinical outcomes and possible complications in OSA patients before and after MISS MLS.Design and settingSystematic review and meta‐analysis. Six databases were searched, and the PRISMA guideline was followed.ParticipantsPatients with OSA receiving MISS MLS.Main outcome measuresThe random‐effects model was adopted for the statistical synthesis. The percentage and 95% confidence interval (CI) were adopted as the effect measurements of MISS MLS for OSA. Subgroup analyses and sensitivity analyses were also performed to identify the heterogeneity among the studies.ResultsThere were initially 154 articles for identification. Eventually, six studies with a total of 848 OSA patients completely met the inclusion criteria and were further enrolled for analysis. The pooled analysis showed statistically significant lower AHI (apnea/hypopnea index, /hr.; mean difference: −8.931, 95% CI: −11.591 to −6.271, I2 = 87.4%), ESS (mean difference: −2.947, 95% CI: −4.465 to −1.429, I2 = 94.9%), and snoring severity with 0‐10 visual analog scale after surgery (mean difference: −4.966, 95% CI: −5.804 to −4.128, I2 = 96.4%). The success rate was 46% in mild/moderate OSA; however, 18% in severe OSA. There were no major complications occurred.ConclusionsThe acceptable surgical outcomes, esp. in mild/moderate OSA, and rare complications are the major advantages of MISS MLS. The evidence of this study could aid the decision making in selecting suitable treatment programs for OSA patients.

Funder

Ministry of Science and Technology

Publisher

Wiley

Subject

Otorhinolaryngology

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