Tonsillectomy is one of the most common surgical procedures and, given the limited efficacy of conservative treatment, remains the primary approach for managing palatine tonsillitis (PT) and palatine tonsillar hypertrophy (PTH). Both conditions negatively affect quality of life (QoL), increase healthcare costs, and contribute to work absenteeism. Objectives: The primary aim of this study is to assess QoL following tonsillectomy and uvulopalatopharyngoplasty (UPPP) in patients qualified for surgical treatment due to PT and PTH. Methods: A prospective cohort study was conducted among 89 adults (85% follow-up) who had undergone tonsillectomy and UPPP. QoL was assessed 6 years post-op using the Glasgow Benefit Inventory (GBI), the Schwentner questionnaire, and VAS. The study group included 89 patients (85% of those who underwent surgery), including 26 women (29%) and 63 men (71%). Results: Patients with PT and PTH showed significant QoL improvement after palatine tonsillectomy. The mean GBI score indicated QoL improvement after both tonsillectomy (+25.7) and UPPP (+15.8), with the most pronounced improvements in physical and general health. Overall, GBI scores were higher in PT compared to PTH (26.6 compared to 15.5), mainly due to better results in the physical health domain (55.9 compared to 12.9). Conclusions: Palatine tonsillectomy has a positive impact on QoL in both PT and PTH patients, with higher questionnaire scores observed in the PT group. Tonsillectomy contributed more significantly to the improvement in QoL than UPPP, as measured by the GBI, the Schwentner questionnaire, and the Visual Analogue Scale (VAS). Furthermore, our study demonstrated that, when evaluating and qualifying patients for tonsillectomy, a more comprehensive otolaryngological assessment should be conducted, including evaluation of the nasal cavity and nasopharynx, as comorbid conditions in these regions are correlated with postoperative QoL outcomes.

Diseases of the palatine tonsils may be associated with varying degrees of subjective daytime sleepiness (SDS), a symptom that may affect daily functioning. This study evaluated long-term changes in SDS in patients before and after tonsillectomy or uvulopalatopharyngoplasty (UPPP). The primary aim of this study was to evaluate long-term changes in SDS following tonsillectomy or UPPP. Secondary objectives included the assessment of patient satisfaction and the influence of demographic and clinical factors, including sex, age, chronic diseases, tonsil size, and histopathological findings, on treatment outcomes. A prospective cohort study included 105 adult patients, with an 85% follow-up rate: 89 patients (26 women, 63 men). SDS was assessed using the Epworth Sleepiness Scale before surgery and after a mean follow-up of 6 years. Additional analyses considered demographic and clinical variables. Patient satisfaction was measured using a visual analog scale and willingness to undergo repeat surgery. Both tonsillectomy and UPPP were associated with a significant long-term reduction in SDS. The mean ESS score decreased from 7.29 preoperatively to 4.37 at follow-up ( P < .05). A clinically meaningful improvement in ESS of ≥2 points was achieved in 71.9% of patients, and the proportion of patients with normal ESS scores (≤10) increased from 75.3% to 92.1% ( P < .001). While the unadjusted ESS reduction was greater after UPPP than after tonsillectomy (4.22 vs 1.81 points), multivariable analysis demonstrated a significant interaction between surgical procedure and baseline ESS, indicating that the magnitude of improvement differed between procedures according to baseline subjective sleepiness. Sex, tonsil size, histopathological findings, and chronic diseases did not significantly influence the outcomes. Tonsillectomy and UPPP were associated with a sustained, long-term reduction in SDS. The magnitude of postoperative improvement increased with baseline subjective sleepiness, with the relative difference between procedures becoming greater at higher baseline ESS values. These findings suggest that upper airway surgery may be associated with durable improvements in patient-reported daytime sleepiness, including among patients with baseline ESS scores within the non-EDS range.

Introduction: Obstructive sleep apnea (OSA) is a disorder with a complex, most often multilevel pathophysiology. In patients with tongue base involvement, transoral robotic surgery (TORS) is one of the modern surgical treatment options.Aim: To assess postoperative outcomes of transoral robotic surgery for OSA and to evaluate the role of drug-induced sleep endoscopy (DISE) in preoperative assessment and surgical planning.Materials and methods: A retrospective single-center analysis was performed in 30 consecutive adult patients operated on for OSA between 2023 and 2026. All patients were qualified for surgery based on suspected tongue base obstruction. In each case, DISE was performed in the operating room immediately before surgery using a standardized propofol-based anesthetic protocol. The extent of surgery was individualized according to the clinical assessment and DISE findings and included single-level or multilevel procedures. Transoral robotic surgery using the da Vinci Xi system was performed at the palatal level (robot-assisted modified UPPP), the tongue base, or both. Treatment efficacy was assessed on the basis of changes in the apnea-hypopnea index (AHI) and the proportion of patients meeting Sher criteria for surgical success. Postoperative assessment was based on follow-up polygraphy performed at least 6 months after surgery.Results: The study group included 5 women (17%), and patient age ranged from 28 to 73 years. Mean age was 50 years, and mean preoperative AHI was 34/h. DISE showed palatal obstruction in 97% of patients, while significant tongue base involvement was confirmed in 83%. Postoperative polygraphy performed at least 6 months after surgery was available in 24 of the 30 patients. The remaining 6 patients declined follow-up assessment. The analysis of AHI outcomes and surgical success was based on the 24 patients with postoperative polygraphy. Mean AHI reduction was 43.3% and Sher success criteria were met in 14 of 24 patients (58.3%). In patients with moderate OSA the mean AHI reduction was 28.9%, compared with 73.4% in severe OSA. Two cases of prolonged intubation related to tongue edema and two cases of postoperative bleeding were recorded.Conclusions: In this cohort, individualized surgical treatment using TORS was associated with a reduction in AHI, while DISE was useful in planning the extent of surgery. Patients with severe OSA showed greater mean AHI reduction and a higher Sher success rate than those with moderate OSA.