ABSTRACT Objectives This study compares postoperative outcomes of transoral robotic surgery (TORS) and traditional lingual tonsillectomy in pediatric patients with persistent obstructive sleep apnea (OSA) following tonsillectomy and adenoidectomy (T 25 TORS and 445 traditional procedures). Postoperative dysphagia was significantly higher among TORS (32%) versus traditional (1.3%; p < 0.001). Postoperative infection rates were greater after TORS (16% vs. 1.3%; χ 2 = 14.88, p < 0.001). Meta‐analysis demonstrated significantly greater postoperative bleeding with TORS (12%) versus traditional (3%, χ 2 = 3.98, p = 0.046). AHI reduction was greater in TORS (mean: 16.20 events/h, 95% CI: 9.01–23.39) than in traditional (mean: 3.64 events/h, 95% CI: 2.03–5.25), with a significant subgroup difference ( χ 2 = 11.41, p < 0.001) indicating greater symptom resolution following TORS. No significant differences were observed in postoperative airway obstruction or bleeding requiring surgical intervention. Conclusion Although TORS offers greater improvements in persistent pediatric OSA following T&A, its association with higher rates of postoperative dysphagia, infection, and bleeding warrants careful decision‐making and further investigation in larger cohorts to refine patient selection and optimize outcomes.
Dabbas et al. (Fri,) studied this question.