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Volume 14 No. 08
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Accepted Papers

Scientific Investigations

Trans-Oral Robotic Tongue Reduction for OSA: Does Lingual Anatomy Influence the Surgical Outcome?

Giovanni Cammaroto, MD1,2; Giuseppe Meccariello, MD2; Matteo Costantini, MD3; Francesco Stomeo, MD4; Paul Hoff5; Filippo Montevecchi, MD2; Claudio Vicini, MD2,4
1Department of Otolaryngology, University of Messina, Messina, Italy; 2Department of Special Surgery, ENT and Oral Surgery Unit, Ospedale Morgagni Pierantoni, Forlì, Italy; 3Department of Pathology, Ospedale Morgagni Pierantoni, Forlì, Italy; 4Department of Otolaryngology, University of Ferrara, Ferrara, Italy; 5Department of Otolaryngology, Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan

Study Objectives:

To evaluate both the influence of the volume of the excised base of tongue (BOT) on the surgical outcome after robotic tongue reduction in patients affected by obstructive sleep apnea (OSA) and the role of the lymphatic or muscular predominance within the removed tissue.


Fifty-one patients with OSA were included in this study. All patients were treated with a robotic tongue base reduction. Data registered for the analysis were: age, sex, preoperative body mass index, preoperative and postoperative apnea-hypopnea index (AHI), delta AHI (preoperative AHI − postoperative AHI), total volume of the excised BOT, total thickness of excised BOT, isolated lymphatic thickness and soft tissue thickness (including muscular component) of the excised BOT, and lymphatic/soft tissue ratio (lymphatic thickness / soft tissue thickness).


A statistically significant reduction of AHI values was seen postoperatively, and a success rate of 74.5% was recorded. However, no significant correlations between delta AHI and tongue volume in cubic centimeters, lymphatic/soft tissue ratio, and total thickness were found.


These findings reinforce the general opinion that OSA is not only influenced by anatomic factors but other phenomena may play a fundamental role in its genesis. A deeper understanding of OSA pathogenesis is needed in order to tailor an individual treatment strategy that could lead to a more effective therapy.


Cammaroto G, Meccariello G, Costantini M, Stomeo F, Hoff P, Montevecchi F, Vicini C. Trans-oral robotic tongue reduction for OSA: does lingual anatomy influence the surgical outcome? J Clin Sleep Med. 2018;14(8):1347–1351.

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