Therapeutic Efficacy of Endoscope‐Guided Coblation for Tongue Base Reduction as Part of Multilevel Surgery in Moderate to Severe OSA Patients

ABSTRACT Objective Obstructive sleep apnea (OSA) frequently results from multilevel upper airway obstruction involving the palate, lateral walls, and tongue base. Among various techniques, endoscope‐guided coblation for tongue base reduction (TBR) provides precise resection with excellent hemostasis and minimal morbidity. This study aimed to evaluate the therapeutic efficacy and safety of endoscope‐guided coblation for TBR as a component of multilevel surgery in patients with moderate to severe OSA. Study Design Case series. Setting Single‐institution academic tertiary medical center. Subjects and Methods The study included 92 OSA patients (85 males and 7 females) with identified tongue base (TB) narrowing in a single tertiary center. Patient demographics, subjective symptoms, polysomnography parameters, drug‐induced sleep endoscopy findings, positive airway pressure data, and postoperative complications following endoscopic coblation TBR were retrospectively reviewed. Results The mean age of the patients was 40.8 ± 12.8 years, and the mean body‐mass index was 26.8 ± 4.0 kg/m 2 . The success rate of endoscopic coblation TBR was 56.1% in moderate or severe OSA patients, with 66.7% showing significant improvement in sleep parameters. The preoperative apnea‐hypopnea index (AHI) was 47.3 ± 22.2 events/hr, which decreased to 27.8 ± 23.8 events/hr postoperatively at 6 months. Supine AHI, apnea index (AI), and lowest oxygen saturation (SpO 2 ) were also significantly improved. Sleep efficiency and REM percentage increased substantially. Postoperative complications were minimal, with pain being the most common complaint, which rarely lasted longer than a week. Conclusion Endoscope‐guided coblation TBR, when incorporated into multilevel sleep surgery, significantly improves polysomnographic outcomes, including AHI, oxygen saturation, and sleep efficiency, while maintaining a favorable safety profile. This approach offers a practical, cost‐effective, and minimally invasive alternative, broadening access to effective upper airway surgery for OSA patients.