The Effect of Glossectomy for Obstructive Sleep Apnea: A Systematic Review and Meta-analysis

Objective Determine the effect of glossectomy as part of multilevel sleep surgery on sleep-related outcomes in patients with obstructive sleep apnea. Data Sources PubMED, Scopus. Review Methods Two independent researchers conducted the review using PubMed-NCBI and Scopus literature databases. Studies on glossectomy for obstructive sleep apnea that reported pre- and postoperative apnea-hypopnea index (AHI) score with 10 or more patients were included. Results A total of 18 articles with 522 patients treated with 3 glossectomy techniques (midline glossectomy, lingualplasty, and submucosal minimally invasive lingual excision) met inclusion criteria. Pooled analyses (baseline vs post surgery) showed a significant improvement in AHI (48.1 22.01 to 19.05 +/- 15.46, P < .0001), Epworth Sleepiness Scale (ESS; 11.41 +/- 4.38 to 5.66 +/- 3.29, P < .0001), snoring visual analog scale (VAS; 9.08 +/- 1.21 to 3.14 +/- 2.41, P < .0001), and Lowest O-2 saturation (76.67 +/- 10.58 to 84.09 +/- 7.90, P < .0001). Surgical success rate was 59.6% (95% CI, 53.0%-65.9%) and surgical cure was achieved in 22.5% (95% CI, 11.26%-36.26%) of cases. Acute complications occurred in 16.4% (79/481) of reported patients. Glossectomy was used as a standalone therapy in 24 patients. In this limited cohort, significant reductions in AHI (41.84 +/- 32.05 to 25.02 +/- 20.43, P = .0354) and ESS (12.35 +/- 5.05 to 6.99 +/- 3.84, P < .0001) were likewise observed. Conclusion Glossectomy significantly improves sleep outcomes as part of multilevel surgery in adult patients with OSA. Currently, there is insufficient evidence to analyze the role of glossectomy as a standalone procedure for the treatment of sleep apnea, although the evidence suggests positive outcomes in select patients.