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    Comparison of fiber delivered CO2 laser and electrocautery in transoral robot assisted tongue base surgery
    (Springer, 2017) Karaman, Murat; Gün, Taylan; Temelkuran, Burak; Aynacı, Engin; Kaya, Cem; Tekin, Ahmet Mahmut
    To compare intra-operative and post-operative effectiveness of fiber delivered CO2 laser to monopolar electrocautery in robot assisted tongue base surgery. Prospective non-randomized clinical study. Twenty moderate to severe obstructive sleep apnea (OSA) patients, non-compliant with Continuous Positive Airway Pressure (CPAP), underwent Transoral Robotic Surgery (TORS) using the Da Vinci surgical robot in our University Hospital. OSA was treated with monopolar electrocautery in 10 patients, and with flexible CO2 laser fiber in another 10 patients. The following parameters in the two sets are analyzed: Intraoperative bleeding that required cauterization, robot operating time, need for tracheotomy, postoperative self-limiting bleeding, length of hospitalization, duration until start of oral intake, pre-operative and post-operative minimum arterial oxygen saturation, pre-operative and post-operative Epworth Sleepiness Scale score, postoperative airway complication and postoperative pain. Mean follow-up was 12 months. None of the patients required tracheotomy and there were no intraoperative complications related to the use of the robot or the CO2 laser. The use of CO2 laser in TORS-assisted tongue base surgery resulted in less intraoperative bleeding that required cauterization, shorter robot operating time, shorter length of hospitalization, shorter duration until start of oral intake and less postoperative pain, when compared to electrocautery. Postoperative apnea-hypopnea index scores showed better efficacy of CO2 laser than electrocautery. Comparison of postoperative airway complication rates and Epworth sleepiness scale scores were found to be statistically insignificant between the two groups. The use of CO2 laser in robot assisted tongue base surgery has various intraoperative and post-operative advantages when compared to monopolar electrocautery.
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    Comparison of radiofrequency and transoral robotic surgery in obstructive sleep apnea syndrome treatment
    (Taylor and Francis Ltd, 2018) Aynacı, Engin; Karaman, Murat; Kersin, Burak; Fındık, Mahmut Ozan
    Introduction: Radiofrequency tissue ablation (RFTA) and transoral robotic surgery (TORS) are the methods used in OSAS surgery. We also aimed to compare the advantages and disadvantages of RF and TORS as treatment methods applied in OSAS patients in terms of many parameters, especially apnea hypopnea index (AHI). Materials and methods: Patients were classified by performing a detailed examination and evaluation before surgery. 20 patients treated with anterior palatoplasty and uvulectomy-/+ tonsillectomy + RFTA (17 males, 3 females) and 20 patients treated with anterior palatoplasty and uvulectomy-/+ tonsillectomy + TORS (16 males, 4 females) were included in the study. PSG was performed preoperatively and postoperatively in all patients and Epworth sleepiness questionnaire was applied. All operations were performed by the same surgeon and these surgical methods -RF and TORS- were compared in terms of many parameters. Results: When the patients treated with RF and TORS were compared in operation time, length of hospitalization and duration of transition to oral feeding; all parameters were significantly greater in the patients treated with TORS. Conclusions: TORS technique was found to be more successful than RF in terms of reduction of AHI value, correcting minimum arterial oxygen saturation value and decreasing Epworth Sleepiness Scale score.
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    Investigation of the effectiveness of surgical treatment on respiratory functions in patients with obstructive sleep apnea syndrome
    (Sage Publications Inc, 2020) Kersin, Burak; Karaman, Murat; Aynacı, Engin; Keleş, Ahmet
    Objective: Obstructive sleep apnea syndrome (OSAS) is a problem that involves many bodily systems and its effects on the respiratory system deserve special attention. Although many studies exist that investigate respiratory functions in patients using continuous positive airway pressure (CPAP) for the treatment of sleep apnea, there is a lack of research regarding the effect of OSAS surgery on respiratory function in the literature, which has motivated us to perform such a study. Materials and Methods: Thirty-two patients diagnosed with OSAS with an apnea hypopnea index ranging between 15 and 30 and had undergone robotic tongue base resection and uvulopharyngoplasty were included as study participants. Pulmonary function tests were performed on all participants 1 day prior to, and at 3 and 6 months after the operation. Weight and body mass indices (BMIs) were also recorded at the same intervals for all participants. Data were electronically recorded and analyzed through SPSS 22.0. Values ofP< .05 have been considered as statistically significant. Results: Average age of the 32 participants was 43.2 +/- 10.7, average body weight was 94.1 +/- 12.6, and average BMI was 31.4 +/- 4.7. Decreases in body weight and BMI values recorded at 3 and 6 months postoperatively had statistical significance when compared with values recorded preoperatively (P< .05). Comparisons made in terms of pulmonary functions revealed a statistically significant increase in 3 and 6-month postoperative values of FVC, FEV1, FEV1/FVC, PEF, and FEF 25-75 (P< .05). Conclusion: Our study shows the positive effects of robotic tongue base resection and uvulopharyngoplasty operation on respiratory function parameters. This suggests that surgical treatment in OSAS patients is as effective as CPAP on respiratory function.