Endoscope-guided coblator tongue base resection using an endoscope-holding system for obstructive sleep apnea

Abstract

Background. Multilevel obstruction in obstructive sleep apnea commonly includes retroglossal obstruction. To improve surgical success rates, tongue volume reduction with posterior midline glossectomy and/or lingual tonsillectomy is widely performed. Methods. Nasotracheal intubation was utilized, and the combined tongue procedure was performed as a final step after palatal surgery. The tongue was pulled maximally by a retraction suture and a McIVOR (Karl Storz, Tuttlingen, Germany) or Davis mouth gag (Karl Storz, Tuttlingen, Germany), and a medium-length tongue blade was applied to expose the tongue base. A 70-degree rigid endoscope was fixed by the holding system and introduced into the oral cavity. Endoscope-guided coblator tongue base resection was then performed. Results. The surgeon could use both hands for the surgery, enabling a more delicate resection of tongue base tissue. Conclusion. This technique was acceptable and can be successfully used in patients with a large tongue, in whom exposing the tongue base for surgery is difficult. (C) 2015 Wiley Periodicals, Inc.