Volume 148, Issue 1 p. 166-171
Sleep Medicine and Surgery

Evaluation of Open Midline Glossectomy in the Multilevel Surgical Management of Obstructive Sleep Apnea Syndrome

Gerald D. Suh MD

Corresponding Author

Gerald D. Suh MD

Section of Otolaryngology, St Johns–Riverside Hospital, Yonkers, New York, USA

Department of Otolaryngology, Mt Sinai Medical Center, New York, New York, USA

Department of Otolaryngology, Long Island Jewish Medical Center, New Hyde Park, New York, USA

Gerald D. Suh, MD, Board Certified in Otolaryngology and Sleep Medicine, ENT and Allergy Associates, LLP, 201-33 26th Avenue, Bayside, NY 11360, USA Email: [email protected]Search for more papers by this author
First published: 12 October 2012
Citations: 2

No sponsorships or competing interests have been disclosed for this article.

Abstract

Objective

To analyze the overall success rate of open midline glossectomy with lingual tonsillectomy in the surgical management of obstructive sleep apnea syndrome (OSAS) as well as a subset analysis to determine whether certain patient factors influence clinical outcome.

Study Design

Case series with retrospective data collection.

Setting

Private practice with surgeries performed at a single community hospital (St Johns–Riverside Hospital).

Subjects and Methods

Fifty consecutive patients who had moderate to severe OSAS with Friedman tongue position III or IV and underwent midline glossectomy with lingual tonsillectomy as part of multilevel sleep apnea surgery and had pre- and postsurgery in-laboratory sleep studies performed.

Results

The overall success rate was 56.0% using success defined as a postoperative apnea-hypopnea index (AHI) less than 20 and a decrease of greater than 50%. Median AHI decreased from 52.0 to 18.3 with a median change of −26.1 (interquartile range, −41.6 and −17.1). Of significance on subset analysis, patients with a preoperative AHI <60 had a 68.8% success rate (P =. 02), and patients with Friedman tongue position III had a 75.9% success rate (P =. 0009).

Conclusion

The findings of this case series would suggest that multilevel sleep apnea surgery, incorporating midline glossectomy with lingual tonsillectomy, is a valid alternative for managing moderate to severe OSAS in patients who do not respond or are resistant to continuous positive airway pressure therapy. In patients with a preoperative AHI <60 or Friedman tongue position III, surgical success rate is significantly improved.