S G MacKay1, N Jefferson1, L Grundy2, R Lewis3. 1. Department of Otolaryngology Head Neck Surgery, The Wollongong Hospital, Australia. 2. Department of Anaesthesia, The Wollongong Hospitaland, Australia. 3. Department of Otolaryngology Head and Neck Surgery, Royal Perth Hospital, Australia.
Abstract
BACKGROUND: Obstructive sleep apnoea is a common condition that is unfortunately associated with a high rate of patient non-compliance regarding device use. Newer surgical interventions have focused on procedures at the palate level, using variants of palatoplasty and transpalatal advancement. However, the extent of tongue reduction surgery required remains controversial. The authors propose an in-between variant that combines midline glossectomy resection (with minimal mucosal sacrifice) and lateral coblation tongue channelling. METHOD: Four patients underwent a coblation-assisted Lewis and MacKay operation, which is a new technique for tongue reduction. This involved a midline glossectomy combined with lateral coblation channelling of the tongue, alone or as part of major airway reconstruction. Demographic, polysomnographic and quality of life questionnaire data were collected prospectively and analysed. RESULTS AND CONCLUSION: No significant complications were noted in the four patients. (Results of the post-surgical outcomes are presented in another paper.) The coblation-assisted Lewis and MacKay operation reduced the potential complications of aggressive tongue surgery. The contours of the tongue were maintained, but significant reduction was still achieved.
BACKGROUND: Obstructive sleep apnoea is a common condition that is unfortunately associated with a high rate of patient non-compliance regarding device use. Newer surgical interventions have focused on procedures at the palate level, using variants of palatoplasty and transpalatal advancement. However, the extent of tongue reduction surgery required remains controversial. The authors propose an in-between variant that combines midline glossectomy resection (with minimal mucosal sacrifice) and lateral coblation tongue channelling. METHOD: Four patients underwent a coblation-assisted Lewis and MacKay operation, which is a new technique for tongue reduction. This involved a midline glossectomy combined with lateral coblation channelling of the tongue, alone or as part of major airway reconstruction. Demographic, polysomnographic and quality of life questionnaire data were collected prospectively and analysed. RESULTS AND CONCLUSION: No significant complications were noted in the four patients. (Results of the post-surgical outcomes are presented in another paper.) The coblation-assisted Lewis and MacKay operation reduced the potential complications of aggressive tongue surgery. The contours of the tongue were maintained, but significant reduction was still achieved.
Authors: T Verse; A Dreher; C Heiser; M Herzog; J T Maurer; W Pirsig; K Rohde; N Rothmeier; A Sauter; A Steffen; S Wenzel; B A Stuck Journal: HNO Date: 2016-05 Impact factor: 1.284
Authors: T Verse; A Dreher; C Heiser; M Herzog; J T Maurer; W Pirsig; K Rohde; N Rothmeier; A Sauter; A Steffen; S Wenzel; B A Stuck Journal: Sleep Breath Date: 2016-05-14 Impact factor: 2.816