Objectives: Removal of part of the tongue base, in combination with uvulopharyngopalatoplasty via transoral robotic surgery (TORS), for treating obstructive sleep apnea syndrome (OSAS) results in enlargement of the oropharynx and hypopharynx and change in the size of the resonance chamber. These procedures may also alter the laryngeal-hyoid bone complex, which is linked to vocal fold tension. Thus, there is the potential for change in phonation and pitch after surgery.Study Design: Prospective, nonrandomized, institutional board-approved study.Methods: From January to August 2018, 15 patients with OSAS receiving TORS underwent voice and pitch sampling. The multi-dimensional voice program (MDVP) was applied to the evaluation of preoperative sound parameters. Highest pitch and lowest pitch were obtained with real-time pitch software, with pitch synchronized to electronic organ or tuner. Subjects also completed the Voice Handicap Index-10 scale (VHI-10), to assess their subjective perception and to detect factors affecting the VHI-10 score. The relevant parameters were analyzed again 3 months after the operation.Results: There was an increase in VHI-10 score 3 months after operation that did not reach statistical significance. There were also no significant differences in sound parameters. Increases in highest pitch (353.18 Hz shift to 387.99 Hz), highest semitone (F5# shift to F5#), lowest pitch (117.45 Hz shift to 131.42 Hz), and lowest semitone (C₃ shift to C₃) did not reach statistical significance. The increase in the lowest semitone was significantly related to change in VHI-10 score (r = −0.808, P = 0.028).Conclusion: Patients with OSA undergoing TORS showed a negative correlation coefficient over 0.8 with change in VHI-10 score. That is, increase in the lowest semitone after operation correlated with increase in VHI-10 score which may cause perceive changes in subjective pronunciation.

Since the outbreak of the novel coronavirus disease 2019 (COVID-19), the epidemic has gradually slowed down in various countries and people’s lives have gradually returned to normal. To monitor the spread of the epidemic, studies discussing the design of related healthcare information systems have been increasing recently. However, these studies might not consider the aspect of user-centric design when developing healthcare information systems. This study examined these innovative technology applications and rapidly built prototype systems for smart healthcare through a systematic literature review and a study of patient innovation. The design guidelines for the Smart Healthcare System (SHS) were then compiled through an expert review process. This will provide a reference for future research and similar healthcare information system development.

Obstructive sleep apnea (OSA), lower urinary tract symptoms (LUTS), and erectile dysfunction (ED) are chronic conditions that seriously affect middle-aged men. This study aimed to evaluate the changes in the presence of these conditions after transoral robotic surgery (TORS) for OSA. This prospective observational study recruited 48 men with moderate-to-severe OSA (mean age 40.6 ± 8.1 years) who underwent TORS from October 2019 to November 2021 at a tertiary center. Baseline polysomnographic parameters, Epworth Sleepiness Scale (ESS), and demographic characteristics were measured. The evaluations of LUTS and ED were based on self-administered International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF-5) questionnaires, respectively, before TORS. The treatment outcomes were assessed three months postoperatively in the patients undergoing TORS due to moderate-to-severe OSA. There was significant Apnea-Hypopnea Index (AHI) reduction from 53.10 ± 25.77 to 31.66 ± 20.34 three months after undergoing TORS (p < 0.001). There was also a significant decrease in the total IPSS score (5.06 ± 5.42 at baseline to 2.98 ± 2.71 at three months postoperatively, p = 0.001), the storage domain, and the voiding domain (p < 0.05). The ED also improved significantly, as seen in the IIEF score (20.98 ± 3.32 to 22.17± 3.60, p = 0.007). The reduction of AHI was associated with changes in body weight and the lowest oxygen saturation (SpO₂) levels during sleep (rho = 0.395, p = 0.005; rho = 0.526, p < 0.001, respectively). However, the reduction in AHI was not significantly associated with improvement in IPSS or IIEF scores (p > 0.05). For men with moderate-to-severe OSA, TORS can significantly improve the polysomnography parameters, sleep-related questionnaire scores, and quality of life, and alleviate ED and LUTS. AHI reduction is not a crucial factor for ED and LUTS improvement after TORS for OSA, especially in ED.

Obstructive sleep apnea–hypopnea syndrome (OSAHS) is a chronic disorder with significant comorbidities. Transoral robotic surgery (TORS) combined with uvulopalatopharyngoplasty (UPPP) is an established treatment, but postoperative pain management remains challenging. This study evaluates the efficacy of dinalbuphine sebacate (DNS), an extended-release analgesic, in reducing opioid use and managing postoperative pain in TORS UPPP patients. This retrospective cohort included consecutive TORS-UPPP patients from 1 January 2020 to 30 June 2024; the database was locked on 30 June 2024 prior to analysis. The patients were divided into a DNS group (n = 96) and a conventional analgesia (CA) group (n = 42). The DNS group received a 150 mg intramuscular injection after anesthetic induction and after the surgery. Analgesic consumption, opioid usage, and pain scores were evaluated from the day of surgery (POD0) to two days postoperatively (POD2), as well as opioid prescriptions at discharge and during the first follow-up. The DNS group exhibited a significantly lower percentage of opioid use during POD0–POD2 (30.21% vs. 54.76%, p < 0.001) and a reduced oral morphine equivalent dose (15.31 ± 36.68 mg vs. 56.79 ± 85.83 mg, p = 0.001). Opioid prescriptions at discharge (68.75% vs. 88.10%, p = 0.016) and at the first follow-up (13.54% vs. 52.38%, p < 0.001) were also lower in the DNS group, with comparable analgesic effects. DNS effectively reduces postoperative opioid consumption and prescription in TORS UPPP patients without significant adverse effects. These findings support the integration of DNS into multimodal analgesia protocols for OSAHS surgery, substantially reduced inpatient and post-discharge opioid use (NNT ≈ 3–5) with small, likely non-clinically important differences in pain scores and no significant safety signal, supporting its clinical relevance in OSAHS surgical programs. Warranting further multicenter validation.

Background: Flavor sensation was the joint perception of smell and taste sensation was associated with the pleasure of life. Obstructive sleep apnea (OSA) had been demonstrated the presence of upper airway remodeling which altered sensory and motor function due to hypoxia or snore vibration. This study aims to investigate whether OSA is associated with the risk of flavor disorder (FD). Methods: We conducted a nationwide cohort study using the Taiwan National Health Insurance Research Database, one million subjects were sampled with data collected from 1999 to 2013 and 9,191 identified diagnosed OSA patients were included. Each patient was matched with non-OSA controls from the general population by propensity score matching (1:1) based on age, gender, hypertension, hyperlipidemia, ankylosing spondylitis, and Charlson comorbidity index, 8,037 OSA and an equal number of non-OSA subjects were used to compared in this study. The incidence of FD was assessed at the end of 2013 and cumulative incidences, hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. Results: The adjusted HR (aHR)of FD for the OSA group was 2.082-fold (95% CI = 1.149–3.773, p=0.0155) higher than non-OSA group. The stratified analyses revealed aHR of FD for the hyperlipidemia group was 2.264-fold (95% CI = 1.061–4.832, p=0.035). Subgroup analysis showed the subjected of female OSA had more risk to develop FD (aHR:2.345, 95% CI = 1.026–5.357, p=0.043). Conclusion: A higher risk of developing FD was found among the newly diagnosed OSA cohort during the longer than 10-year follow-up period