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Background: Obstructive Sleep Apnea Syndrome (OSA) is a kind of sleep disorder. The symptoms are intermittent, partial or complete upper airway collapse, seriously impacting oxygen saturation and oxidative stress. Some patients choose to do upper airway surgeries, but the success rate is only 60-70%. The symptoms might relapse because of aging and gaining weights. The purpose of our study is to compare the effect of transoral robotic surgery (TORS) and oropharyngeal rehabilitation (OPR) on patients after TORS. Methods: Participants above 20 years old who are newly diagnosed with mild to severe OSA (Apnea-hypopnea Index >5/h), and the physician will explain the treatment programs to every subject in clinic. Expected results: The hypothesis of this study is the success rate of surgery will be enhance by increasing tongue and jaw-opening muscle strength after OPR. The biomarkers of cardiovascular disease may decrease and both the collapse of upper airway and sleep quality may be improved after TORS and OPR.
The participants above 20 years old who are newly diagnosed with mild to severe OSA (Apnea-hypopnea Index >5/h), and the physician will explain the treatment programs to every subject. By their willingness to choose the therapeutic method, the participants who select the surgery interventions will be assign to TORS or TORS+OPR group. The matched controls as well as age-, sex-, and body mass index-matched OSA participants will be selected from the patients who are waiting for oral appliance, losing weight and using continuous positive airway pressure. Before surgery, 6 week and 18 week after surgery, the investiagters will compare the polysomnography data, questionnaires of sleep quality, drug-induced sleep endoscopy and computed tomography as primary outcomes. The investigators will also compare the tongue and jaw-opening muscle strength and biomarkers of oxidative stress, anti-oxidative stress, inflammatory cytokines and matrix metalloproteinases 9 as secondary outcomes. The OPR would begin at 6 week after surgery, and participants will undergo three months of the home-based oropharyngeal myofunctional therapeutic training. During the training intervention period, participants will be interviewed one time per week for adjusting the treatment intensity.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control | Sham Comparator | Without the willingness of surgery, those participants waiting for oral appliance (Device), losing weights and using continuous positive airway pressure (Device) were distribute to control group. |
|
| Transoral robotic surgery (TORS) | Experimental | The participants underwent TORS. TORS is a kind of surgery that the surgeons would remove the tonsils and the fat tissue of tongue base and suspend the soft palate. |
|
| TORS+OPR | Experimental | The participants started OPR 6 weeks after TORS. Each exercise was repeated 10 times, 1-3 cycles per day, 3-5 sessions per week at their home and performed for 3 months. Patients were supervised by physical therapist once a week for 30 minutes. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| transoral robotic surgery | Procedure | transoral robotic surgery (TORS) which remove the extra soft tissue of the base of the tongue and soft palate in this study |
|
| Measure | Description | Time Frame |
|---|---|---|
| Apnea Hypopnea Index (AHI) | Polysomnography included electroencephalographic, electro-oculographic, thoracic and abdominal respiratory inductance plethysmography and body position sensor to confirm the sleeping stage in one-night observation. Above measurements will be aggregated to arrive AHI. Unabbreviated scale title:Apnea and Hypopnea index The minimum value:0 The maximum values: none Higher scores mean a worse outcome. | through study completion, an average of 6 months |
| Computer Tomography (CT)_Volume | All patients underwent CT in a supine position. Each patient was instructed to maintain his/her tongue in the resting position, without swallowing, during CT. Volume from hard palate to the base of epiglottis was measured. | through study completion, an average of 6 months |
| Computer Tomography (CT)_minimal Area | All patients underwent CT in a supine position. Each patient was instructed to maintain his/her tongue in the resting position, without swallowing, during CT. Cross section area on the tip of epiglottis was measured. | through study completion, an average of 6 months |
| Computer Tomography (CT)_AP Distance | All patients underwent CT in a supine position. Each patient was instructed to maintain his/her tongue in the resting position, without swallowing, during CT. Anterior to posterior distance on the tip of epiglottis was measured. | through study completion, an average of 6 months |
| Computer Tomography (CT)_Lateral Distance | All patients underwent CT in a supine position. Each patient was instructed to maintain his/her tongue in the resting position, without swallowing, during CT. Lateral distance on the tip of epiglottis was measured. | through study completion, an average of 6 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| National Cheng Kung University Hospital | Tainan | Please Select | 412 | Taiwan |
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Recruited time:2020/01/01-2022/05/11
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| ID | Title | Description |
|---|---|---|
| FG000 | Control | Without the willingness of surgery, those participants waiting for oral appliance (Device), losing weights and using continuous positive airway pressure (Device) were distribute to control group. oral appliance: It is a kind of treatment for the participants who refuse surgeries and choose to use other kinds of conservative treatment. The conservative treatments included oral appliance, losing weights and using continuous positive airway pressure. The oral appliance would be wore only at night and it would press the soft palate and protrude the jaw. using continuous positive airway pressure: The participants only used CPAP at night. The device composed of a main machine, pipe and mask. The participants would instruct to wore the mask. The main machine would give positive airway pressure to open the airway and avoid collapsing. losing weights: The participants would ask to lose weight by changing their diets and exercising, without using drugs and surgeries. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jun 9, 2020 |
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| oral appliance | Device | It is a kind of treatment for the participants who refuse surgeries and choose to use other kinds of conservative treatment. The conservative treatments included oral appliance, losing weights and using continuous positive airway pressure. The oral appliance would be wore only at night and it would press the soft palate and protrude the jaw. |
|
| using continuous positive airway pressure | Device | The participants only used CPAP at night. The device composed of a main machine, pipe and mask. The participants would instruct to wore the mask. The main machine would give positive airway pressure to open the airway and avoid collapsing. |
|
|
| losing weights | Behavioral | The participants would ask to lose weight by changing their diets and exercising, without using drugs and surgeries. |
|
| oropharyngeal rehabilitation | Combination Product | OPR included exercise for soft palate, tongue and oropharynx. There are 13 movements in OPR. The movements would be teach by a physical therapist. |
|
|
| Drug-induced Sleep Endoscopy (DISE) | All patients underwent DISE in a supine position. The possible outcomes were unilevel collapse at the velum, oropharynx, tongue base, or epiglottis and multilevel collapse at any of these locations. The velum is the part of the upper airway at the level of the soft palate and uvula; the oropharynx is the pharyngeal portion at the level of the tonsils, above the tongue base. The tongue base was considered the retroglossal area; epiglottis was considered the pharyngeal region below the tongue base. The degree of obstruciton was diagnosed by an ear nose throat surgeon. The degree of obstruction ranged from 0 to 2. 0: no obstruction (<50%); 1: partial obstruction (50-75%); 2: complete obstruction (>75%). | through study completion, an average of 6 months |
| Jaw Opening Muscle Strength | Muscle strength of jaw was measured with a 'handheld' dynamometer (MicroFET○R2, Hoggan Scientific, USA) mounted on an adapted ophthalmic examination frame, to avoid alterations in chin and head position and to ensure consistent compression. | through study completion, an average of 6 months |
| Tongue Protrusion Muscle Strength | The muscle strength of the tongue was evaluated by the IOPI system, model 2.2 (Northwest, Co., LLC, Carnation, WA, USA). | through study completion, an average of 6 months |
| Tongue Elevation Muscle Strength | The muscle strength of the tongue was evaluated by the IOPI system, model 2.2 (Northwest, Co., LLC, Carnation, WA, USA). | through study completion, an average of 6 months |
| Tongue Depression Muscle Strength | The muscle strength of the tongue was evaluated by the IOPI system, model 2.2 (Northwest, Co., LLC, Carnation, WA, USA). | through study completion, an average of 6 months |
| Tongue Lateralization Muscle Strength | The muscle strength of the tongue was evaluated by the IOPI system, model 2.2 (Northwest, Co., LLC, Carnation, WA, USA). | through study completion, an average of 6 months |
| FG001 | Transoral Robotic Surgery (TORS) | The participants underwent TORS. TORS is a kind of surgery that the surgeons would remove the tonsils and the fat tissue of tongue base and suspend the soft palate. transoral robotic surgery: transoral robotic surgery (TORS) which remove the extra soft tissue of the base of the tongue and soft palate in this study |
| FG002 | TORS+OPR | The participants started OPR 6 weeks after TORS. Each exercise was repeated 10 times, 1-3 cycles per day, 3-5 sessions per week at their home and performed for 3 months. Patients were supervised by physical therapist once a week for 30 minutes. transoral robotic surgery: transoral robotic surgery (TORS) which remove the extra soft tissue of the base of the tongue and soft palate in this study oropharyngeal rehabilitation: OPR included exercise for soft palate, tongue and oropharynx. There are 13 movements in OPR. The movements would be teach by a physical therapist. |
| COMPLETED |
|
| NOT COMPLETED |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Control | Without the willingness of surgery, those participants waiting for oral appliance (Device), losing weights and using continuous positive airway pressure (Device) were distribute to control group. oral appliance: It is a kind of treatment for the participants who refuse surgeries and choose to use other kinds of conservative treatment. The conservative treatments included oral appliance, losing weights and using continuous positive airway pressure. The oral appliance would be wore only at night and it would press the soft palate and protrude the jaw. using continuous positive airway pressure: The participants only used CPAP at night. The device composed of a main machine, pipe and mask. The participants would instruct to wore the mask. The main machine would give positive airway pressure to open the airway and avoid collapsing. losing weights: The participants would ask to lose weight by changing their diets and exercising, without using drugs and surgeries. |
| BG001 | Transoral Robotic Surgery (TORS) | The participants underwent TORS. TORS is a kind of surgery that the surgeons would remove the tonsils and the fat tissue of tongue base and suspend the soft palate. transoral robotic surgery: transoral robotic surgery (TORS) which remove the extra soft tissue of the base of the tongue and soft palate in this study |
| BG002 | TORS+OPR | The participants started OPR 6 weeks after TORS. Each exercise was repeated 10 times, 1-3 cycles per day, 3-5 sessions per week at their home and performed for 3 months. Patients were supervised by physical therapist once a week for 30 minutes. transoral robotic surgery: transoral robotic surgery (TORS) which remove the extra soft tissue of the base of the tongue and soft palate in this study oropharyngeal rehabilitation: OPR included exercise for soft palate, tongue and oropharynx. There are 13 movements in OPR. The movements would be teach by a physical therapist. |
| BG003 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants | Participants |
| ||||||||||||||||
| Age, Continuous | Mean | Standard Deviation | years |
| |||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||
| Race/Ethnicity, Customized | Count of Participants | Participants |
| ||||||||||||||||
| Region of Enrollment | Count of Participants | Participants |
| ||||||||||||||||
| Polysomonography | Apnea hypopnea index (AHI) is the main measurement, so the mean and SD below was for AHI. Apnea was defined as a reduction in airflow >90% lasting >10 seconds.The definition of hypopnea was a reduction in airflow >30% lasting >10 seconds and a decrease in oxygen saturation >3% or presence of microarousal. AHI quantifies the severity of sleep apnea by counting the number of apneas and hypopneas during sleep. Mild sleep apnea means 5< =AHI<15; Moderate sleep apnea means 15< =AHI<30; Severe sleep apnea means AHI >=30 | Mean | Standard Deviation | events per hour |
| ||||||||||||||
| Body mass index | using weight and height and the formula is kg/m^2 | Mean | Standard Deviation | kg/m^2 |
| ||||||||||||||
| Neck circumference | Using the unit as centimeter | Mean | Standard Deviation | cm |
| ||||||||||||||
| Tongue protrusion muscle strength | Mean | Standard Deviation | kPa |
| |||||||||||||||
| Tongue elevation muscle strength | Mean | Standard Deviation | kPa |
| |||||||||||||||
| Tongue depression muscle strength | Mean | Standard Deviation | kPa |
| |||||||||||||||
| Tongue lateralization muscle strength | Mean | Standard Deviation | kPa |
| |||||||||||||||
| Computed Tomography_ Volume | Volume from hard palate to epiglottis tip | Mean | Standard Deviation | cm^3 |
| ||||||||||||||
| Computed Tomography_ minimal area | Minimal area on the epiglottis tip | Mean | Standard Deviation | cm^2 |
| ||||||||||||||
| Computed Tomography_ AP distance | Anterior to posterior distance on epiglottis tip | Mean | Standard Deviation | cm |
| ||||||||||||||
| Computed Tomography_ lateral distance distance | Left to right distance on epiglottis tip. Unit was measured in centimeter. | Mean | Standard Deviation | cm |
| ||||||||||||||
| Drug-induced sleep endoscopy | Count of Participants | Participants |
| ||||||||||||||||
| Jaw opening muscle strength | Mean | Standard Deviation | kg |
|
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Apnea Hypopnea Index (AHI) | Polysomnography included electroencephalographic, electro-oculographic, thoracic and abdominal respiratory inductance plethysmography and body position sensor to confirm the sleeping stage in one-night observation. Above measurements will be aggregated to arrive AHI. Unabbreviated scale title:Apnea and Hypopnea index The minimum value:0 The maximum values: none Higher scores mean a worse outcome. | Seven participants didn't complete the whole protocol, so we didn't analyze their data. | Posted | Mean | Standard Deviation | events per hour | through study completion, an average of 6 months |
|
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| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Primary | Computer Tomography (CT)_Volume | All patients underwent CT in a supine position. Each patient was instructed to maintain his/her tongue in the resting position, without swallowing, during CT. Volume from hard palate to the base of epiglottis was measured. | Seven participants didn't complete the whole protocol, so we didn't analyze their data. | Posted | Mean | Standard Deviation | cm^3 | through study completion, an average of 6 months |
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Primary | Computer Tomography (CT)_minimal Area | All patients underwent CT in a supine position. Each patient was instructed to maintain his/her tongue in the resting position, without swallowing, during CT. Cross section area on the tip of epiglottis was measured. | Seven participants didn't complete the whole protocol, so we didn't analyze their data. | Posted | Mean | Standard Deviation | cm^2 | through study completion, an average of 6 months |
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Primary | Computer Tomography (CT)_AP Distance | All patients underwent CT in a supine position. Each patient was instructed to maintain his/her tongue in the resting position, without swallowing, during CT. Anterior to posterior distance on the tip of epiglottis was measured. | Seven participants didn't complete the whole protocol, so we didn't analyze their data. | Posted | Mean | Standard Deviation | cm | through study completion, an average of 6 months |
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| Primary | Computer Tomography (CT)_Lateral Distance | All patients underwent CT in a supine position. Each patient was instructed to maintain his/her tongue in the resting position, without swallowing, during CT. Lateral distance on the tip of epiglottis was measured. | Seven participants didn't complete the whole protocol, so we didn't analyze their data. | Posted | Mean | Standard Deviation | cm | through study completion, an average of 6 months |
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Primary | Drug-induced Sleep Endoscopy (DISE) | All patients underwent DISE in a supine position. The possible outcomes were unilevel collapse at the velum, oropharynx, tongue base, or epiglottis and multilevel collapse at any of these locations. The velum is the part of the upper airway at the level of the soft palate and uvula; the oropharynx is the pharyngeal portion at the level of the tonsils, above the tongue base. The tongue base was considered the retroglossal area; epiglottis was considered the pharyngeal region below the tongue base. The degree of obstruciton was diagnosed by an ear nose throat surgeon. The degree of obstruction ranged from 0 to 2. 0: no obstruction (<50%); 1: partial obstruction (50-75%); 2: complete obstruction (>75%). | Seven participants didn't complete the whole protocol, so we didn't analyze their data. | Posted | Count of Participants | Participants | No | through study completion, an average of 6 months |
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Primary | Jaw Opening Muscle Strength | Muscle strength of jaw was measured with a 'handheld' dynamometer (MicroFET○R2, Hoggan Scientific, USA) mounted on an adapted ophthalmic examination frame, to avoid alterations in chin and head position and to ensure consistent compression. | Seven participants didn't complete the whole protocol, so we didn't analyze their data. | Posted | Mean | Standard Deviation | kilogram force | through study completion, an average of 6 months |
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| Primary | Tongue Protrusion Muscle Strength | The muscle strength of the tongue was evaluated by the IOPI system, model 2.2 (Northwest, Co., LLC, Carnation, WA, USA). | Seven participants didn't complete the whole protocol, so we didn't analyze their data. | Posted | Mean | Standard Deviation | kilopascals | through study completion, an average of 6 months |
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| Primary | Tongue Elevation Muscle Strength | The muscle strength of the tongue was evaluated by the IOPI system, model 2.2 (Northwest, Co., LLC, Carnation, WA, USA). | Seven participants didn't complete the whole protocol, so we didn't analyze their data. | Posted | Mean | Standard Deviation | kilopascals | through study completion, an average of 6 months |
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| Primary | Tongue Depression Muscle Strength | The muscle strength of the tongue was evaluated by the IOPI system, model 2.2 (Northwest, Co., LLC, Carnation, WA, USA). | Seven participants didn't complete the whole protocol, so we didn't analyze their data. | Posted | Mean | Standard Deviation | kilopascals | through study completion, an average of 6 months |
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Primary | Tongue Lateralization Muscle Strength | The muscle strength of the tongue was evaluated by the IOPI system, model 2.2 (Northwest, Co., LLC, Carnation, WA, USA). | Seven participants didn't complete the whole protocol, so we didn't analyze their data. | Posted | Mean | Standard Deviation | kilopascals | through study completion, an average of 6 months |
|
6 months
None of the participants at risk for serious adverse events and all-cause mortality is zero becaurse control group only used conservative treatment and TORS is a safe surgery for surgery group and surgery + OPR group.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Control | Without the willingness of surgery, those participants waiting for oral appliance (Device), losing weights and using continuous positive airway pressure (Device) were distribute to control group. oral appliance: It is a kind of treatment for the participants who refuse surgeries and choose to use other kinds of conservative treatment. The conservative treatments included oral appliance, losing weights and using continuous positive airway pressure. The oral appliance would be wore only at night and it would press the soft palate and protrude the jaw. using continuous positive airway pressure: The participants only used CPAP at night. The device composed of a main machine, pipe and mask. The participants would instruct to wore the mask. The main machine would give positive airway pressure to open the airway and avoid collapsing. losing weights: The participants would ask to lose weight by changing their diets and exercising, without using drugs and surgeries. | 0 | 20 | 0 | 20 | 0 | 20 |
| EG001 | Transoral Robotic Surgery (TORS) | The participants underwent TORS. TORS is a kind of surgery that the surgeons would remove the tonsils and the fat tissue of tongue base and suspend the soft palate. transoral robotic surgery: transoral robotic surgery (TORS) which remove the extra soft tissue of the base of the tongue and soft palate in this study | 0 | 42 | 0 | 42 | 0 | 42 |
| EG002 | TORS+OPR | The participants started OPR 6 weeks after TORS. Each exercise was repeated 10 times, 1-3 cycles per day, 3-5 sessions per week at their home and performed for 3 months. Patients were supervised by physical therapist once a week for 30 minutes. transoral robotic surgery: transoral robotic surgery (TORS) which remove the extra soft tissue of the base of the tongue and soft palate in this study oropharyngeal rehabilitation: OPR included exercise for soft palate, tongue and oropharynx. There are 13 movements in OPR. The movements would be teach by a physical therapist. | 0 | 19 | 0 | 19 | 0 | 19 |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Yi-Ju, Lai | Department of Physical Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan | +886963123117 | jasmine19900728@gmail.com |
| Jul 23, 2024 |
| Prot_SAP_000.pdf |
| ICF | No | No | Yes | Informed Consent Form | Jun 9, 2020 | Jul 23, 2024 | ICF_001.pdf |
| ID | Term |
|---|---|
| D020181 | Sleep Apnea, Obstructive |
| ID | Term |
|---|---|
| D012891 | Sleep Apnea Syndromes |
| D001049 | Apnea |
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
| D020919 | Sleep Disorders, Intrinsic |
| D020920 | Dyssomnias |
| D012893 | Sleep Wake Disorders |
| D009422 | Nervous System Diseases |
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| Between 18 and 65 years |
|
| >=65 years |
|
| Male |
|
The participants underwent TORS. TORS is a kind of surgery that the surgeons would remove the tonsils and the fat tissue of tongue base and suspend the soft palate.
transoral robotic surgery: transoral robotic surgery (TORS) which remove the extra soft tissue of the base of the tongue and soft palate in this study
| OG002 | TORS+OPR | The participants started OPR 6 weeks after TORS. Each exercise was repeated 10 times, 1-3 cycles per day, 3-5 sessions per week at their home and performed for 3 months. Patients were supervised by physical therapist once a week for 30 minutes. transoral robotic surgery: transoral robotic surgery (TORS) which remove the extra soft tissue of the base of the tongue and soft palate in this study oropharyngeal rehabilitation: OPR included exercise for soft palate, tongue and oropharynx. There are 13 movements in OPR. The movements would be teach by a physical therapist. |
|
|
|
The participants underwent TORS. TORS is a kind of surgery that the surgeons would remove the tonsils and the fat tissue of tongue base and suspend the soft palate.
transoral robotic surgery: transoral robotic surgery (TORS) which remove the extra soft tissue of the base of the tongue and soft palate in this study
| OG002 | TORS+OPR | The participants started OPR 6 weeks after TORS. Each exercise was repeated 10 times, 1-3 cycles per day, 3-5 sessions per week at their home and performed for 3 months. Patients were supervised by physical therapist once a week for 30 minutes. transoral robotic surgery: transoral robotic surgery (TORS) which remove the extra soft tissue of the base of the tongue and soft palate in this study oropharyngeal rehabilitation: OPR included exercise for soft palate, tongue and oropharynx. There are 13 movements in OPR. The movements would be teach by a physical therapist. |
|
|
|
The participants underwent TORS. TORS is a kind of surgery that the surgeons would remove the tonsils and the fat tissue of tongue base and suspend the soft palate.
transoral robotic surgery: transoral robotic surgery (TORS) which remove the extra soft tissue of the base of the tongue and soft palate in this study
| OG002 | TORS+OPR | The participants started OPR 6 weeks after TORS. Each exercise was repeated 10 times, 1-3 cycles per day, 3-5 sessions per week at their home and performed for 3 months. Patients were supervised by physical therapist once a week for 30 minutes. transoral robotic surgery: transoral robotic surgery (TORS) which remove the extra soft tissue of the base of the tongue and soft palate in this study oropharyngeal rehabilitation: OPR included exercise for soft palate, tongue and oropharynx. There are 13 movements in OPR. The movements would be teach by a physical therapist. |
|
|
|
The participants underwent TORS. TORS is a kind of surgery that the surgeons would remove the tonsils and the fat tissue of tongue base and suspend the soft palate.
transoral robotic surgery: transoral robotic surgery (TORS) which remove the extra soft tissue of the base of the tongue and soft palate in this study
| OG002 | TORS+OPR | The participants started OPR 6 weeks after TORS. Each exercise was repeated 10 times, 1-3 cycles per day, 3-5 sessions per week at their home and performed for 3 months. Patients were supervised by physical therapist once a week for 30 minutes. transoral robotic surgery: transoral robotic surgery (TORS) which remove the extra soft tissue of the base of the tongue and soft palate in this study oropharyngeal rehabilitation: OPR included exercise for soft palate, tongue and oropharynx. There are 13 movements in OPR. The movements would be teach by a physical therapist. |
|
|
|
| OG001 | Transoral Robotic Surgery (TORS) | The participants underwent TORS. TORS is a kind of surgery that the surgeons would remove the tonsils and the fat tissue of tongue base and suspend the soft palate. transoral robotic surgery: transoral robotic surgery (TORS) which remove the extra soft tissue of the base of the tongue and soft palate in this study |
| OG002 | TORS+OPR | The participants started OPR 6 weeks after TORS. Each exercise was repeated 10 times, 1-3 cycles per day, 3-5 sessions per week at their home and performed for 3 months. Patients were supervised by physical therapist once a week for 30 minutes. transoral robotic surgery: transoral robotic surgery (TORS) which remove the extra soft tissue of the base of the tongue and soft palate in this study oropharyngeal rehabilitation: OPR included exercise for soft palate, tongue and oropharynx. There are 13 movements in OPR. The movements would be teach by a physical therapist. |
|
|
|
The participants underwent TORS. TORS is a kind of surgery that the surgeons would remove the tonsils and the fat tissue of tongue base and suspend the soft palate.
transoral robotic surgery: transoral robotic surgery (TORS) which remove the extra soft tissue of the base of the tongue and soft palate in this study
| OG002 | TORS+OPR | The participants started OPR 6 weeks after TORS. Each exercise was repeated 10 times, 1-3 cycles per day, 3-5 sessions per week at their home and performed for 3 months. Patients were supervised by physical therapist once a week for 30 minutes. transoral robotic surgery: transoral robotic surgery (TORS) which remove the extra soft tissue of the base of the tongue and soft palate in this study oropharyngeal rehabilitation: OPR included exercise for soft palate, tongue and oropharynx. There are 13 movements in OPR. The movements would be teach by a physical therapist. |
|
|
|
| OG002 | TORS+OPR | The participants started OPR 6 weeks after TORS. Each exercise was repeated 10 times, 1-3 cycles per day, 3-5 sessions per week at their home and performed for 3 months. Patients were supervised by physical therapist once a week for 30 minutes. transoral robotic surgery: transoral robotic surgery (TORS) which remove the extra soft tissue of the base of the tongue and soft palate in this study oropharyngeal rehabilitation: OPR included exercise for soft palate, tongue and oropharynx. There are 13 movements in OPR. The movements would be teach by a physical therapist. |
|
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| OG002 | TORS+OPR | The participants started OPR 6 weeks after TORS. Each exercise was repeated 10 times, 1-3 cycles per day, 3-5 sessions per week at their home and performed for 3 months. Patients were supervised by physical therapist once a week for 30 minutes. transoral robotic surgery: transoral robotic surgery (TORS) which remove the extra soft tissue of the base of the tongue and soft palate in this study oropharyngeal rehabilitation: OPR included exercise for soft palate, tongue and oropharynx. There are 13 movements in OPR. The movements would be teach by a physical therapist. |
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| OG002 | TORS+OPR | The participants started OPR 6 weeks after TORS. Each exercise was repeated 10 times, 1-3 cycles per day, 3-5 sessions per week at their home and performed for 3 months. Patients were supervised by physical therapist once a week for 30 minutes. transoral robotic surgery: transoral robotic surgery (TORS) which remove the extra soft tissue of the base of the tongue and soft palate in this study oropharyngeal rehabilitation: OPR included exercise for soft palate, tongue and oropharynx. There are 13 movements in OPR. The movements would be teach by a physical therapist. |
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| OG002 | TORS+OPR | The participants started OPR 6 weeks after TORS. Each exercise was repeated 10 times, 1-3 cycles per day, 3-5 sessions per week at their home and performed for 3 months. Patients were supervised by physical therapist once a week for 30 minutes. transoral robotic surgery: transoral robotic surgery (TORS) which remove the extra soft tissue of the base of the tongue and soft palate in this study oropharyngeal rehabilitation: OPR included exercise for soft palate, tongue and oropharynx. There are 13 movements in OPR. The movements would be teach by a physical therapist. |
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| complete obstruction |
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| complete obstruction |
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| complete obstruction |
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