Surgical Management of Tongue-Related Obstructive Sleep Apnea

Preoperative Considerations

• The European Respiratory Society recommends hyoid suspension as an isolated procedure for OSA patients with retrolingual/hypopharyngeal obstruction 1, 2
• Tongue base reduction procedures may be necessary in cases of severe macroglossia, as suggested by the European Respiratory Society 2, 3

Surgical Outcomes

• Surgical success rates for tongue-based procedures decrease with increasing BMI and AHI, according to the European Respiratory Society 1, 3
• The European Respiratory Society suggests that tongue base soft tissue procedures alone, including tongue suspension, cannot be recommended as a single treatment option for obese patients with moderate to severe OSA 4, 6
• Multilevel surgery combining procedures at both the palatal and tongue base levels may be more effective for patients with combined retropalatal and retrolingual/hypopharyngeal obstruction, as recommended by the European Respiratory Society 1, 7

Postoperative Care

• Surgical complications of tongue procedures may include temporary dysphagia, odynophagia, and floor of mouth infections, as reported by the European Respiratory Society 4, 5
• Post-treatment follow-up should include polysomnography to objectively assess improvement, as suggested by the European Respiratory Society 8