Imperial College London
Portrait Picture

Dr George Garas BSc (Hons) MBBS (Dist) PhD DIC FRCS (ORL-HNS) FEBORL-HNS (Gold Medal)

Faculty of Medicine, Department of Surgery & Cancer

Honorary Clinical Senior Lecturer
 
 
 
//

Contact

 

g.garas

 
 
//

Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Arora:2015:10.1007/s11325-015-1293-9,
author = {Arora, A and Chaidas, K and Garas, G and Amlani, A and Darzi, A and Kotecha, B and Tolley, NS},
doi = {10.1007/s11325-015-1293-9},
journal = {Sleep and Breathing},
pages = {739--747},
title = {Outcome of TORS to tongue base and epiglottis in patients with OSA intolerant of conventional treatment},
url = {http://dx.doi.org/10.1007/s11325-015-1293-9},
volume = {20},
year = {2015}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - PurposeTransoral robotic surgery (TORS) of the tongue base with or without epiglottoplasty represents a novel treatment for obstructive sleep apnea (OSA). The objective was to evaluate the clinical efficacy of TORS of the tongue base with or without epiglottoplasty in patients who had not tolerated or complied with conventional treatment (continuous positive airway pressure or oral appliance).MethodsFour-year prospective case series. The primary outcome measure was the apnea-hypopnea index (AHI) in combination with the Epworth Sleepiness Score (ESS). Mean oxygen saturation levels (SaO2) before and after TORS on respective sleep studies were also recorded. Secondary outcome measures included operative time and complications. Patient reported outcome measures (PROMs) assessed included voice, swallow and quality of life.ResultsFourteen patients underwent TORS for tongue base reduction with ten having additional wedge epiglottoplasty. A 64 % success rate was achieved with a normal post-operative sleep study in 36 % of cases at 6 months. There was a 51 % reduction in the mean AHI (36.3 ± 21.4 to 21.2 ± 24.6, p = 0.02) and a sustained reduction in the mean Epworth Sleepiness Score (p = 0.002). Mean SaO2 significantly increased after surgery compared to pre-operative values (92.9 ± 1.8 to 94.3 ± 2.5, p = 0.005). Quality of life showed a sustained improvement 3 months following surgery (p = 0.01). No major complications occurred.ConclusionsTORS of the tongue base with or without epiglottoplasty represents a promising treatment option with minimal morbidity for selected patients with OSA. Long-term prospective comparative evaluation is necessary to validate the findings of this study.
AU  - Arora,A
AU  - Chaidas,K
AU  - Garas,G
AU  - Amlani,A
AU  - Darzi,A
AU  - Kotecha,B
AU  - Tolley,NS
DO  - 10.1007/s11325-015-1293-9
EP  - 747
PY  - 2015///
SN  - 1522-1709
SP  - 739
TI  - Outcome of TORS to tongue base and epiglottis in patients with OSA intolerant of conventional treatment
T2  - Sleep and Breathing
UR  - http://dx.doi.org/10.1007/s11325-015-1293-9
UR  - http://hdl.handle.net/10044/1/51660
VL  - 20
ER  -
Download