{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:40:38Z","timestamp":1787841638317,"version":"build-2784847793"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>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&amp;A).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search of Ovid MEDLINE, Embase, Cochrane CENTRAL, and Web of Science was conducted through January 2026. Inclusion criteria: pediatric patients (&lt;\u200918\u2009years) with persistent OSA following T&amp;A, TORS, or traditional lingual tonsillectomy. Outcomes assessed included postoperative apnea\u2013hypopnea index (AHI) reduction, bleeding, and non\u2010bleeding complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 17 studies were analyzed (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009470; 25 TORS and 445 traditional procedures). Postoperative dysphagia was significantly higher among TORS (32%) versus traditional (1.3%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Postoperative infection rates were greater after TORS (16% vs. 1.3%;\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200914.88,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Meta\u2010analysis demonstrated significantly greater postoperative bleeding with TORS (12%) versus traditional (3%,\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20093.98,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.046). AHI reduction was greater in TORS (mean: 16.20 events\/h, 95% CI: 9.01\u201323.39) than in traditional (mean: 3.64 events\/h, 95% CI: 2.03\u20135.25), with a significant subgroup difference (\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200911.41,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) indicating greater symptom resolution following TORS. No significant differences were observed in postoperative airway obstruction or bleeding requiring surgical intervention.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although TORS offers greater improvements in persistent pediatric OSA following T&amp;A, its association with higher rates of postoperative dysphagia, infection, and bleeding warrants careful decision\u2010making and further investigation in larger cohorts to refine patient selection and optimize outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lio2.70491","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T10:52:12Z","timestamp":1784890332000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Transoral Robotic Surgery Versus Traditional Lingual Tonsillectomy for Persistent Pediatric Sleep Apnea"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0550-5802","authenticated-orcid":false,"given":"Mona","family":"Dabbas","sequence":"first","affiliation":[{"name":"Georgetown University School of Medicine  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7473-2066","authenticated-orcid":false,"given":"Christina","family":"Zhu","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8505-1996","authenticated-orcid":false,"given":"Emily","family":"Clementi","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine  Washington DC USA"},{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Georgetown University Hospital  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samay","family":"Sampat","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen","family":"Mathew","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Earl","family":"Harley","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Georgetown University Hospital  Washington DC 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