TransOral Robotic Surgery

Sleep apnea is a disorder of upper airway collapse. It is diagnosed by a sleep study. Untreated patients with moderate to severe sleep apnea tend to die early from heart attacks, strokes, or auto accidents. Patients with sleep apnea are usually prescribed positive airway pressure (PAP). PAP therapy works well for 80% of the patients. However, 20% of patients are unable to tolerate PAP therapy.

Causes of PAP failure include:

  • Mask falling off at night
  • Nasal stuffiness
  • Problems with mask fit
  • Claustrophobia
  • Feeling less rested with PAP
  • Not wanting to sleep with a mask/machine for the rest of your life

    • Trans-oral robotic surgery for sleep apnea is the latest surgical advance. It uses the da Vinci robotic system, a treatment that has been used successfully to perform lingual tonsillectomy for cancers of the tongue base. Combining robotic surgery of the lingual tonsils and tongue base has markedly better cure rates for sleep apnea compared to prior techniques.

    Advantages of robotic lingual tonsillectomy and partial glossectomy for sleep apnea include:

    • Higher cure rate of sleep apnea
    • Better identification of site of airway blockage by drug induced sleep endoscopy
    • Superior lighting magnification and 3-D viewer
    • Robotic arms with more range of motion, better precision, and improved scaling than the human hand
    • Precise measurement of the volume of tissue removed allows for consistency

    The best candidates for this state-of-the-art procedure will share the following characteristics:

    • Diagnosis of sleep apnea on a sleep study
    • Failed positive airway pressure (PAP) therapy
    • May have failed prior sleep apnea surgery
    • Need to open the mouth a minimum of one centimeter
    • Evidence of lingual tonsil enlargement and tongue base collapse seen on sleep endoscopy
    • Body mass index (BMI) of 34 or less

    If you have sleep apnea and are not using PAP on a regular basis you should obtain a consultation regarding trans-oral robotic surgery for sleep apnea (TORS).