Transoral robotic tongue base reduction and supraglottoplasty combined with maxillomandibular advancement: a new option for selected sleep apnea patients? Preliminary report

  • Iacopo Dallan
  • Lodovica Cristofani-MencacciEmail author
  • Veronica Seccia
  • Christina Cambi
  • Giacomo Fiacchini
  • Stefano Berrettini
  • Bruno Brevi
Head and Neck
Part of the following topical collections:
  1. Sleep Apnea Syndrome: From the pathogenesis to the last therapies



Transoral robotic surgery (TORS) and maxillo-mandibular advancement (MMA) are effective options for obstructive sleep apnea patients. Identification of the correct candidate is by far the most important item in achieving a succesful outcome. As a consequence, not all patients can be managed successfully via one or the other procedure. To overcome the limits of any single procedure we have combined, in a very selected population of patients, TORS tongue base reduction and MMA. Preliminary data are encouraging, in terms of both AHI and ESS.


A retrospective cohort study was conducted on five patients treated with combined TORS-MMA surgery. Demographic and clinical data, pre-operative and post-operative PSG and ESS were collected.


Three of five patients were recruited. All patients presented severe OSAHS. Mean AHI and ESS went respectively from 48 and 12 pre-operatively to 19 and 4 post-operatively. Minor bleeding occurred in two patients. No significant sequelae have been reported.


Combined TORS and MMA is feasible and safe. Our very preliminary data are encouraging, in terms of both AHI and ESS. Long-term follow-up and a larger amount of subjects are needed to confirm this surgical approach as a valuable option for selected OSAHS patient.


Obstructive sleep apnea syndrome Robotic surgical procedure Mandibular advancement TORS OSAHS 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study. Additional informed consent was obtained from all individual participants for whom identifying information is included in this article.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Otorhinolaryngology UnitAzienda Ospedaliero-Universitaria PisanaPisaItaly
  2. 2.Maxillo-Facial UnitAzienda Ospedaliero-Universitaria PisanaPisaItaly

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