Surgical, clinical, and functional outcomes of transoral robotic surgery used in sleep surgery for obstructive sleep apnea syndrome: A systematic review and meta-analysis.

We investigated safety and efficacy of transoral robotic surgery (TORS) for base of tongue (BOT) reduction in obstructive sleep apnea syndrome (OSAS) patients. PubMed, Cochrane Library, and Scopus were searched. A meta-analysis was performed. Random effects models were used. Thirty-one cohorts met our criteria (1693 patients). The analysis was based mostly on retrospective studies. The summary estimate of the reduction of Apnea-Hypoxia Index (AHI) was 24.25 abnormal events per hour (95% CI: 21.69-26.81) and reduction of Epworth Sleepiness Scale (ESS) was 7.92 (95% CI: 6.50-9.34). The summary estimate of increase in lowest O2 saturation was 6.04% (95% CI: 3.05-9.03). The success rate of TORS BOT reduction, either alone or combined with other procedures, was 69% (95% CI: 64-79). The majority of studies reported low level of evidence but suggested that TORS BOT reduction may be a safe procedure associated with improvement of AHI, ESS, and lowest O2 saturation.