Obstructive sleep apnoea can be due to narrowing of the retrolingual space by hypertrophic lingual tonsils. The authors studied 11 patients (five males and six females with a mean age of 44.3 years and a mean BMI of 28.6). All underwent polysomnography and sleep endoscopy to confirm the diagnosis and site of obstruction. Nine patients underwent an MRI to confirm the diagnosis. The indication for surgery was failure/intolerance to continuous positive airway pressure or mandibular advancement devices. The surgery was performed under general endotracheal anaesthesia by a diode laser or by coblation.
Postoperative evaluation was performed at six months and all patients had an improvement in their AHI by around 60%, an improvement of the Epworth scale by 38.3% and improvement of snoring in 66% of patients. The authors conclude that this technique is a relatively simple and safe method in the management of tongue base obstruction in patients who failed non-invasive therapies.
OSAS is a multifactorial problem and management should be tailored for each patient. Most will need more than one line of therapy.