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Background <p>Patients undergoing metabolic bariatric surgery (MBS) have a high prevalence of obstructive sleep apnea (OSA), increasing the risk of postoperative respiratory complications. While tongue thickness has been linked to OSA severity, its role as a predictor of postoperative hypoxemia and other complications remains unclear. This study is the first to evaluate whether preoperative ultrasound-measured tongue thickness correlates with postoperative respiratory outcomes and complications in patients undergoing MBS.&#xa0;</p> Methods <p>This prospective observational cohort study included 119 adult patients undergoing robotic-assisted laparoscopic MBS. Preoperative point-of-care ultrasound was used to measure sagittal and coronal tongue thickness. Continuous postoperative monitoring was performed using the Masimo RAD-97™ system for up to 14&#xa0;h. Outcomes included desaturation events, respiratory and pulse events, and 30-day postoperative complications. Correlations between tongue thickness and clinical outcomes were analyzed and stratified by OSA status.</p> Results <p>Larger tongue dimensions were modestly associated with postoperative desaturation events. Significant time-dependent correlations were observed during the 0–6-h postoperative period (ρ = 0.15—0.34). Patients with OSA showed correlations with desaturations during the first 2&#xa0;h, while patients without OSA had associations during the 4–6-h window. There were no significant differences in tongue size for those with common 30-day complications (p &gt; 0.05).</p> Conclusions <p>Ultrasound-measured tongue thickness is associated with early postoperative oxygen desaturation in patients undergoing MBS, independent of OSA diagnosis. These findings suggest that tongue ultrasound may serve as a noninvasive tool for preoperative respiratory risk stratification. Further studies into comprehensive preoperative anatomical measurements to enhance risk stratification are warranted.</p> Graphical Abstract <p></p>

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Point-of-Care Tongue Ultrasound for Perioperative Risk Stratification in Metabolic Bariatric Surgery

  • 期刊论文

  • 发表日期：

    2025年11月14日

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  • Brandon Dyer,
  • Ryan Shargo,
  • Samantha Malak,
  • Naveen Perisetla,
  • Andrea Vrionis,
  • Jose Malavet,
  • Christopher DuCoin,
  • John Hodgson,
  • Peter Wu,
  • Jeffrey Weiss,
  • Enrico Camporesi

摘要

Background

Patients undergoing metabolic bariatric surgery (MBS) have a high prevalence of obstructive sleep apnea (OSA), increasing the risk of postoperative respiratory complications. While tongue thickness has been linked to OSA severity, its role as a predictor of postoperative hypoxemia and other complications remains unclear. This study is the first to evaluate whether preoperative ultrasound-measured tongue thickness correlates with postoperative respiratory outcomes and complications in patients undergoing MBS. 

Methods

This prospective observational cohort study included 119 adult patients undergoing robotic-assisted laparoscopic MBS. Preoperative point-of-care ultrasound was used to measure sagittal and coronal tongue thickness. Continuous postoperative monitoring was performed using the Masimo RAD-97™ system for up to 14 h. Outcomes included desaturation events, respiratory and pulse events, and 30-day postoperative complications. Correlations between tongue thickness and clinical outcomes were analyzed and stratified by OSA status.

Results

Larger tongue dimensions were modestly associated with postoperative desaturation events. Significant time-dependent correlations were observed during the 0–6-h postoperative period (ρ = 0.15—0.34). Patients with OSA showed correlations with desaturations during the first 2 h, while patients without OSA had associations during the 4–6-h window. There were no significant differences in tongue size for those with common 30-day complications (p > 0.05).

Conclusions

Ultrasound-measured tongue thickness is associated with early postoperative oxygen desaturation in patients undergoing MBS, independent of OSA diagnosis. These findings suggest that tongue ultrasound may serve as a noninvasive tool for preoperative respiratory risk stratification. Further studies into comprehensive preoperative anatomical measurements to enhance risk stratification are warranted.

Graphical Abstract