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Tongue base surgery

Mark A D'Agostino
The standard treatment for patients with obstructive sleep apnea syndrome is positive airway pressure (PAP) therapy. However when PAP therapy fails, surgery maybe an option to alleviate the obstruction. The base of tongue plays an important role in this obstruction, and addressing the tongue base surgically can be a challenge for the head and neck surgeon. Transoral robotic surgery (TORS) using the da Vinci Surgical System provides a safe and effective way to approach and manage the base of tongue and supraglottis...
October 11, 2016: Otolaryngologic Clinics of North America
J S Park, D K Chan, S R Parikh, A K Meyer, K W Rosbe
OBJECTIVE: To study the efficacy of surgical management for obstructive sleep apnea (OSA) syndrome in children with hypotonia, and to identify common anatomic sites of airway obstruction. METHODS: Retrospective chart review of polysomnographic parameters and quality of life instrument scores for seventy eight children with hypotonia who underwent surgical intervention for sleep-disordered breathing at two tertiary children's hospitals, and analysis of drug-induced sleep endoscopy data using a previously validated scoring system...
November 2016: International Journal of Pediatric Otorhinolaryngology
José E Barrera
Multilevel surgery has been established as the mainstay of treatment for the surgical management of obstructive sleep apnea (OSA). Combined with uvulopalatopharyngoplasty, tongue-base surgeries, including the genioglossus advancement (GA), sliding genioplasty, and hyoid myotomy and suspension, have been developed to target hypopharyngeal obstruction. Total airway surgery consisting of maxillomandibular advancement (MMA) with/without GA has shown significant success. Skeletal procedures for OSA with or without a palatal procedure is a proven technique for relieving airway obstruction during sleep...
October 6, 2016: Otolaryngologic Clinics of North America
E Metcalfe, L Aspin, R Speight, E Ermiş, S Ramasamy, K Cardale, K E Dyker, M Sen, R J D Prestwich
AIMS: To determine outcomes after adjuvant radiotherapy for squamous cell carcinoma of the oral cavity and to correlate locoregional recurrence patterns with radiotherapy target volumes. MATERIALS AND METHODS: All patients receiving adjuvant radiotherapy±chemotherapy after surgery with curative intent for oral cavity squamous cell carcinoma between 2007 and 2012 were retrospectively analysed. Locoregional recurrences were reconstructed on the planning computed tomography scan by both deformable image co-registration and by visual assessment...
October 3, 2016: Clinical Oncology: a Journal of the Royal College of Radiologists
Wojciech Golusinski
Anatomically, the oropharynx can be divided into four subsites: the soft palate, pharyngeal wall, base of tongue, and the tonsillar complex. Surgical access to these tumours is often challenging due to the anatomic localization. For this reason, such tumours were traditionally managed with open surgical techniques, usually involving a mandibulotomy, to provide better visualization and access to the oropharynx, followed by free-flap reconstruction of the oropharyngeal defect. However, the invasiveness of this approach could lead to significant morbidity, including speech, swallowing, and airway dysfunction, in addition to poor cosmetic outcomes...
2017: Recent Results in Cancer Research
A García-Kass, A Herrero-Sánchez, G Esparza-Gómez
The cancer which appears in the mobile portion of the tongue is the most common neoplasm of the oral cavity. The objective of this study was to analyse oral tongue cancer epidemiology in a population of 610 patients diagnosed between 1990 and 2008 and detailed in the Tumour Registry of the Madrid region. _Material and Methods: A retrospective analysis based on the following variables provided in the Tumour Registry was achieved: age, gender, histology, stage, location, treatment. Descriptive and analytic statistics with these variables, using Pearson's Chi-square test to study the relationship between the qualitative variables...
October 1, 2016: Medicina Oral, Patología Oral y Cirugía Bucal
Parul Sinha, Pipkorn Patrik, Wade L Thorstad, Hiram A Gay, Bruce H Haughey
OBJECTIVE: The purpose of our study is to compare oncologic and functional outcomes of p16-positive oropharyngeal squamous cell carcinoma (OPSCC) patients, in the presence and absence of planned radiation to the primary bed following transoral surgery (TOS), stratified by T-classification. METHODS: Retrospective cohort study of 261, T1-T4, consecutively TOS-treated OPSCC patients. RESULTS: At a median follow-up of 61months, local recurrence (LR) occurred in 6 (2...
October 2016: Oral Oncology
M Kvezereli-Kopadze, A Kvezereli-Kopadze, M Chikovani
The study was designed to investigate the 5 year old girl with rare bleeding disorder -deficiency of coagulation factor V. The diagnosis was based on detail family history, physical examination and para-clinical data analyses. The age of patient, purpura, this has been detected from early age, positive family history, non-controlled, longtime bleeding, inadequate trauma of the tongue, which did not resolve after surgery, strong hypocoagulation, which was slightly improved, after several plasma transfusions...
July 2016: Georgian Medical News
Da Hee Kim, Hwan Kim, Sanghyun Kwak, Kwangha Baek, Gina Na, Ji Hoon Kim, Se Heon Kim
The da Vinci system (da Vinci Surgical System; Intuitive Surgical Inc.) has rapidly developed in several years from the S system to the Si system and now the Xi System. To investigate the surgical feasibility and to provide workflow guidance for the newly released system, we used the new da Vinci Xi system for transoral robotic surgery (TORS) on a cadaveric specimen. Bilateral supraglottic partial laryngectomy, hypopharyngectomy, lateral oropharyngectomy, and base of the tongue resection were serially performed in search of the optimal procedures with the new system...
October 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Tessho Maruyama, Toshiyuki Nakasone, Akira Matayoshi, Akira Arasaki
As advances in the medical field have resulted in increased life expectancy, performing surgery under general anesthesia in elderly patients has become an important issue. A 99-year-old Okinawan female was admitted to the hospital presenting with pain in the tongue. Following physical examination, a clinical diagnosis of early stage tongue cancer (T2N0Mx) was confirmed. Early stage tongue cancer is particularly easy to access for surgical resection. By contrast, later stages of tongue cancer are associated with pain, dysphagia and throat obstruction...
September 2016: Oncology Letters
Filippo Montevecchi, Chiara Bellini, Giuseppe Meccariello, Paul T Hoff, Elisa Dinelli, Iacopo Dallan, Ruggero M Corso, Claudio Vicini
Pediatric obstructive sleep apnea syndrome (OSAS) is primarily caused by adenotonsillar hypertrophy. However, tongue base hypertrophy is increasingly being recognized as a cause, even after adenotonsillectomy. We report three cases of pediatric OSAS successfully treated by transoral robotic reduction of the tongue base. In all children, we were able to achieve improved retrolingual patency while avoiding significant procedure-related morbidity. In conclusion, tongue base reduction by transoral robotic surgery appears to be a feasible solution for the base of tongue obstruction due to lingual tonsil hypertrophy in pediatric patients...
August 27, 2016: European Archives of Oto-rhino-laryngology
Andrew B Baker, Christopher C Xiao, Brendan P O'Connell, Jay M Cline, M Boyd Gillespie
OBJECTIVES: (1) Determine the rate of postoperative complications, reoperation, readmission, and death after uvulopalatopharyngoplasty (UPPP) for sleep apnea through multi-institutional clinical data. (2) Compare outcomes of UPPP between multilevel and single-level procedures for the treatment of sleep apnea. STUDY DESIGN: Retrospective database analysis. METHODS: The American College of Surgeons National Surgical Quality Improvement Program-a nationally validated, prospective, multi-institutional database from 2005 to 2013-was analyzed for patients who underwent UPPP, per corresponding Current Procedural Terminology codes...
August 23, 2016: Otolaryngology—Head and Neck Surgery
Daniela de Vasconcelos, Adriana de Oliveira Camargo Gomes, Cláudia Marina Tavares de Araújo
Vocal polyps do not have a well-defined therapeutic indication. The recommended treatment is often laryngeal microsurgery, followed by postoperative speech therapy. Speech therapy as the initial treatment for polyps is a new concept and aims to modify inappropriate vocal behavior, adjust the voice quality, and encourage regression of the lesion. This study aimed to determine the effectiveness of the sonorous lips and tongue trill technique in the treatment of vocal polyps. The sample consisted of 10 adults diagnosed with a polyp who were divided into two subgroups: treatment and control...
August 11, 2016: Journal of Voice: Official Journal of the Voice Foundation
Xiang-Juan Tong, Zhan-Gui Tang, Zhen-Feng Shan, Xin-Cheng Guo
BACKGROUND: Surgery remains the first choice of treatment for tongue cancer. Immediate reconstruction should be performed after wide resection of tumour. The aim of this study was to evaluate the anterolateral thigh flap for reconstruction of lingual defects. METHODS: We report 39 consecutive oral tongue squamous cell carcinoma patients who underwent lingual reconstruction with the anterolateral thigh flap between 2009 and 2010. RESULTS: The width of the skin island was 4 to 5 cm and the length of the skin island was 6 to 8 cm in 31 patients with T2 tumour, while the width of the skin island was 5...
2016: World Journal of Surgical Oncology
A I Kryukov, I V Reshetov, L G Kozhanov, A M Sdvizhkov, A L Kozhanov
The objective of the present study was to enhance the effectiveness of rehabilitation of the patients presenting with laryngeal cancer after the resection of the organ and laryngotomy with tracheoesophageal by-pass and endoprosthetics. Our experience in this field is based on the treatment of 102 patients. They were distributed by the nosological forms as follows: primary laryngeal cancer in 97 patients including T1NoMo - 8 (8.2%), T2NoMo - 63 (65%), T3NoMo - 18 (17.6%), T2N1Mo - 1 (0.9%), T4NoMo - 3 (2.9%), and T4N1M0 - 4 (3...
2016: Vestnik Otorinolaringologii
Wolfgang Buchenau, Sarah Wenzel, Margit Bacher, Silvia Müller-Hagedorn, Joerg Arand, Christian F Poets
BACKGROUND: Robin sequence (RS), characterised by micrognathia/retrognathia and glossoptosis with or without cleft palate, presents with intermittent upper airway obstruction and feeding difficulties. Active intervention is required to reduce the risk of brain damage or sudden death. Most treatment options are poorly studied and/or invasive. Our group developed a functional approach including early feeding training and the pre-epiglottic baton plate (PEBP), an orthodontic appliance with a velar extension shifting the base of the tongue forward...
July 19, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Athari Almajed, Alex Viezel-Mathieu, Mirko S Gilardino, Roberto L Flores, Sunil S Tholpady, Aurore Côté
BACKGROUND:   Tongue-lip adhesion (TLA), mandibular distraction osteogenesis (MDO), and subperiosteal release of the floor of the mouth (SPRFM) are the most commonly performed surgical procedures to treat severe airway obstruction in infants born with Pierre Robin sequence (PRS). OBJECTIVES:   To determine the rate of failure of each type of procedure, in terms of mortality and the need for tracheostomy, and to determine what proportion of infants have significant airway obstruction postoperatively as determined by polysomnography (PSG) and compare the data by procedure type...
July 14, 2016: Cleft Palate-craniofacial Journal
Eric J Moore, Kathryn M Van Abel, Kerry D Olsen
OBJECTIVES/HYPOTHESIS: Transoral surgery (TOS) is commonly performed in a supine patient with an oral retractor. Paradoxically, this strategy can create difficulty with visualizing and accessing pathology at the base of tongue, inferior pharynx, and larynx. We investigate the feasibility of TOS with the patient in the seated position. STUDY DESIGN: Pilot study. METHODS: TOS utilizing the da Vinci Robotic Surgical Xi and Si systems (Intuitive Surgical, Sunnyvale, CA) was performed on a fresh cadaver placed in both the traditional supine position and the seated position...
July 5, 2016: Laryngoscope
Stephen C Miller, Shaun A Nguyen, Adrian A Ong, M Boyd Gillespie
OBJECTIVES/HYPOTHESIS: To determine the effect of transoral robotic surgery (TORS) base of tongue (BOT) reduction on sleep-related outcomes in patients with obstructive sleep apnea (OSA). DATA SOURCES: PubMed, Scopus, EMBASE, CINAHL, Cochrane, and Ovid. REVIEW METHODS: Literature search by two independent authors was conducted using the abovementioned databases. Studies on TORS BOT reduction as part of OSA treatment in adult patients with pre- and postoperative apnea-hypopnea index (AHI) scores were included...
June 27, 2016: Laryngoscope
Clemens Heiser, Benedikt Hofauer, Luke Lozier, B Tucker Woodson, Thomas Stark
OBJECTIVE/HYPOTHESIS: Selective stimulation of the upper airway is a new therapy for obstructive sleep apnea. The aim of the study was to determine if a selective nerve integrity monitoring (NIM) system could aid in precise placement of the cuff electrode in selective upper-airway stimulation. STUDY DESIGN: Single-center, prospective clinical trial. METHODS: Twenty patients who received a selective upper-airway stimulation system (Inspire Medical Systems, Maple Grove, MN) were implanted by using a NIM system...
June 27, 2016: Laryngoscope
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