Sleep & breathing = Schlaf & Atmung · 2026
Comparison of upper airway stimulation, tongue base surgeries, and continuous positive airway pressure for moderate-to-severe obstructive sleep apnea: a systematic review and network meta-analysis.
СтатьяСистематический обзорNetwork Meta-AnalysisСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Kim Do Hyun, Jang David W, Hwang Se Hwan
Аннотация
PURPOSE: To compare treatment outcomes of tongue base-targeting interventions-transoral robotic surgery (TORS), plasma ablation tongue base reduction (PATBR), implantable upper airway stimulation (UAS)-and continuous positive airway pressure (CPAP) in moderate-to-severe obstructive sleep apnea (OSA) patients.
METHODS: The PubMed, SCOPUS, Embase, Web of Science, and Cochrane databases were systematically searched through January 2026. A network meta-analysis was conducted to compare tongue-directed surgical procedures (TORS and PATBR), UAS, and CPAP. Outcomes included changes in the apnea-hypopnea index (AHI), Epworth Sleepiness Scale (ESS), lowest oxygen saturation, postoperative hospital stay, success rate (postoperative AHI < 20 with > 50% reduction), and cure rate (postoperative AHI < 5).
RESULTS: Ten studies comprising 758 patients were included. UAS demonstrated significantly greater AHI reduction than TORS (standardized mean difference [SMD] = 1.36 [0.27-2.46]) and significantly improved lowest oxygen saturation (SMD = 1.46 [0.30-2.62]). CPAP showed greater, though not statistically significant, AHI improvement compared with TORS (SMD = 1.17 [- 0.32-2.66]). ESS improvement did not differ significantly among treatments. Both PATBR (SMD = - 1.30 [- 1.80--0.79]) and UAS (SMD = - 5.49 [- 6.65--4.33]) were associated with significantly shorter hospital stays than TORS. Success rates were higher with CPAP (odds ratio [OR] = 3.73 [1.38-10.13]) and UAS (OR = 5.58 [1.97-15.84]) compared to TORS, whereas cure rates were significantly higher with UAS (OR = 12.13 [1.98-74.50]). Ranking analysis indicated overall superiority of UAS across objective outcomes.
CONCLUSIONS: UAS provides superior objective outcomes with shorter hospitalization and comparable subjective improvement, supporting its role as an effective treatment option for moderate-to-severe OSA.
METHODS: The PubMed, SCOPUS, Embase, Web of Science, and Cochrane databases were systematically searched through January 2026. A network meta-analysis was conducted to compare tongue-directed surgical procedures (TORS and PATBR), UAS, and CPAP. Outcomes included changes in the apnea-hypopnea index (AHI), Epworth Sleepiness Scale (ESS), lowest oxygen saturation, postoperative hospital stay, success rate (postoperative AHI < 20 with > 50% reduction), and cure rate (postoperative AHI < 5).
RESULTS: Ten studies comprising 758 patients were included. UAS demonstrated significantly greater AHI reduction than TORS (standardized mean difference [SMD] = 1.36 [0.27-2.46]) and significantly improved lowest oxygen saturation (SMD = 1.46 [0.30-2.62]). CPAP showed greater, though not statistically significant, AHI improvement compared with TORS (SMD = 1.17 [- 0.32-2.66]). ESS improvement did not differ significantly among treatments. Both PATBR (SMD = - 1.30 [- 1.80--0.79]) and UAS (SMD = - 5.49 [- 6.65--4.33]) were associated with significantly shorter hospital stays than TORS. Success rates were higher with CPAP (odds ratio [OR] = 3.73 [1.38-10.13]) and UAS (OR = 5.58 [1.97-15.84]) compared to TORS, whereas cure rates were significantly higher with UAS (OR = 12.13 [1.98-74.50]). Ranking analysis indicated overall superiority of UAS across objective outcomes.
CONCLUSIONS: UAS provides superior objective outcomes with shorter hospitalization and comparable subjective improvement, supporting its role as an effective treatment option for moderate-to-severe OSA.