Post-operative care and complications following transoral robotic surgery for obstructive sleep apnoea.

INTRODUCTION

Transoral robotic surgery for base-of-tongue reduction (TORS-BOT) is an effective treatment for obstructive sleep apnoea (OSA) in patients with tongue base collapse and lingual tonsil hypertrophy. However, post-operative complications may considerably affect recovery. This study evaluated post-operative outcomes, particularly dysphagia, pain management and nutritional challenges, in a Danish cohort.

METHODS

This retrospective cohort study included patients who underwent TORS-BOT at a single Danish centre between April 2022 and September 2024. Data were extracted from electronic medical records. Outcomes included dysphagia, pain management, nasogastric tube (NGT) use and infection rates.

RESULTS

Forty patients, primarily middle-aged, overweight males, underwent TORS-BOT. Most also received additional sleep surgery procedures. The median hospital stay was 3.5 days. Readmission occurred in 20%, mainly due to pain, infection or bleeding. More than 80% experienced complications, with dysphagia (70%) being the most common, often requiring NGT support. Pain control was frequently insufficient, resulting in impaired oral intake. Constipation was prevalent (68%), whereas laxative prophylaxis was inconsistent. Antibiotics were administered to 40%, mainly for aspiration pneumonia.

CONCLUSIONS

Post-operative dysphagia, pain and nutritional issues were common after TORS-BOT for OSA. Standardised post-operative protocols focusing on pain management, dysphagia interventions and nutritional support are needed.

FUNDING: None.

TRIAL REGISTRATION: Not relevant.