Managing Enlarged Tongue Base: Solutions and Concerns for Sleep Apnea

What are the solutions for an enlarged base of the tongue?

Hello, doctor.
Last year, I underwent an examination and found that I have a level 2 obstruction in the retrolingual space during sleep, while the rest were rated 0.
I often have poor sleep and experience light sleep.
My sleep study indicated mild obstructive sleep apnea, but my BMI is only 19.1, and my neck size is normal.
I would like to ask, for patients like me, if I undergo a Da Vinci surgical procedure to remove part of the base of the tongue, will my tongue become enlarged again? I have asked some fellow patients, and they mentioned that recurrence is common, but they are all severe and overweight patients.
I am unsure how significant the correlation is between recurrence and the degree of obesity.

Xing Xing, 30~39 year old female. Ask Date: 2021/11/30

Dr. Li Jiaxuan reply Otolaryngology

The tongue is a regenerative tissue, and it is normal for it to grow back.
Using braces is another option.
Wishing you peace and safety.

Reply Date: 2021/11/30

More Info

Managing an enlarged tongue base can be a significant concern for individuals suffering from obstructive sleep apnea (OSA), especially when it leads to sleep disturbances and poor sleep quality. Your situation, where a sleep study revealed a level 2 obstruction in the tongue base area while maintaining a normal BMI, indicates that factors beyond weight may be contributing to your sleep apnea.
The Da Vinci surgical system is often employed for various surgical procedures, including the removal of portions of the tongue base to alleviate airway obstruction. This minimally invasive technique can be beneficial for patients like you who experience tongue-related obstructions. However, your concern about the potential for the tongue to regain size post-surgery is valid.
Research indicates that while surgical interventions can provide significant relief from OSA symptoms, the long-term outcomes can vary. In patients who are overweight or obese, weight loss is often recommended as a primary strategy to reduce the risk of recurrence of sleep apnea symptoms after surgery. For individuals with a normal BMI, the relationship between tongue size and sleep apnea can be more complex.
The tongue can indeed increase in size due to various factors, including hormonal changes, fluid retention, and even certain medications. However, in your case, if the surgery is successful in removing the obstructive tissue and you maintain a healthy lifestyle, the likelihood of significant regrowth may be lower. It's essential to follow up with your healthcare provider regularly after surgery to monitor any changes and address them promptly.

Additionally, it is crucial to consider other factors that may contribute to your sleep disturbances. For instance, even with a normal BMI, factors such as sleep position, nasal congestion, and overall sleep hygiene can impact sleep quality. Implementing good sleep practices, such as maintaining a consistent sleep schedule, creating a comfortable sleep environment, and avoiding stimulants before bedtime, can also help improve your sleep quality.

If you are concerned about the potential for recurrence of your symptoms post-surgery, discussing these worries with your surgeon or a sleep specialist can provide you with tailored advice. They may suggest additional treatments or lifestyle modifications to help mitigate the risk of recurrence.
In conclusion, while surgical intervention can be effective in managing sleep apnea related to an enlarged tongue base, ongoing monitoring and lifestyle management are crucial for long-term success. Engaging in a comprehensive approach that includes surgical options, lifestyle changes, and regular follow-ups with your healthcare provider can help you achieve better sleep quality and overall health.

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