Clinical Outcomes of Combined Uvulopalatopharyngoplasty and All-Suture Anchor Tongue Base Suspension for Obstructive Sleep Apnea

Background and Objectives: All-suture anchor tongue base suspension (TBS) is a recently introduced approach that provides mandibular fixation without a permanent metallic anchor body. Clinical outcome data for this technique when incorporated into multilevel surgery remain limited. This study evaluated clinical outcomes and postoperative complications following multilevel surgery incorporating all-suture anchor TBS in adults with moderate-to-severe obstructive sleep apnea (OSA). Materials and Methods: This retrospective single-arm observational study included 30 of 40 consecutive adults with polysomnography-confirmed moderate-to-severe OSA who were intolerant of or declined continuous positive airway pressure therapy and had complete postoperative polysomnography and at least 6 months of follow-up. All patients underwent uvulopalatopharyngoplasty combined with all-suture anchor TBS. Preoperative and 6-month postoperative assessments included the apnea-hypopnea index (AHI), nadir oxygen saturation, Epworth Sleepiness Scale (ESS), snoring visual analog scale (VAS), and body mass index (BMI). Results: Median AHI decreased from 50.5 (Q1–Q3, 38.0–68.0) to 15.7 (Q1–Q3, 11.1–21.4) events/h (p < 0.001). ESS improved from 16.3 ± 2.5 to 7.5 ± 2.4 (p < 0.01), and nadir oxygen saturation increased from 68.5% ± 6.5% to 82.8% ± 9.2% (p < 0.01). Surgical success was achieved in 22 patients (73%). Complications were predominantly mild and transient; no infection, suture rupture, or permanent functional deficit occurred. Conclusions: Multilevel surgery incorporating all-suture anchor TBS was associated with significant improvements in objective and subjective sleep outcomes at 6 months, with predominantly mild and transient complications. These findings support the feasibility of incorporating this technique into a multilevel surgical protocol; comparative studies are needed to determine the specific contribution of TBS.