CPT® Code 41512

1. Indications

The tongue base suspension procedure is indicated for patients suffering from obstructive sleep apnea and snoring. These conditions are characterized by repeated episodes of airway obstruction during sleep, leading to disrupted breathing patterns and potential health complications. The procedure aims to alleviate these symptoms by providing support to the tongue base, thereby preventing its backward movement that can obstruct the airway.

• Obstructive Sleep Apnea A condition where the airway becomes blocked during sleep, causing breathing interruptions.
• Snoring A common symptom associated with airway obstruction during sleep, often linked to the position of the tongue.

2. Procedure

The tongue base suspension procedure involves several critical steps to ensure effective placement of the sutures.

• Step 1: A bite block or mouth retractor is placed in the patient's mouth to facilitate exposure of the tongue base, allowing the surgeon to work effectively.
• Step 2: A temporary suture is inserted into the tip of the tongue, which aids in the manipulation of the tongue during the surgical process.
• Step 3: The anterior mandible is palpated intraorally to locate the genioglossal tubercle, which serves as a key anatomical landmark for the procedure.
• Step 4: A stab incision is made at the base of the frenulum to access the underlying tissue.
• Step 5: A screw with an attached suture is inserted into the mandible at the level of the genioglossal tubercle, ensuring it is placed below the roots of the teeth using an inserter device.
• Step 6: The tongue is retracted using the previously placed suture at the tip, which allows for better exposure of the floor of the mouth.
• Step 7: A suture is passed through a previously created insertion hole or incision in the mouth floor and through the tongue, forming a looped suture at the base of the tongue.
• Step 8: The looped suture is threaded from the anterior portion of the tongue to the posterior base on one side, and this process is repeated on the contralateral side.
• Step 9: The screw suture is attached to a needle and passed through the looped suture protruding from the posterior tongue base.
• Step 10: The looped suture is tightened, which moves the screw suture in an anterior direction toward the floor of the mouth, creating a triangular suture pattern that anchors the tongue base.
• Step 11: The suture ends are tied securely, and the posterior tongue base is palpated to confirm that the anchor incision is appropriately placed.
• Step 12: The knot is secured and buried to prevent irritation or complications, and finally, the incision at the base of the tongue is closed.

3. Post-Procedure

Post-procedure care for tongue base suspension typically involves monitoring the patient for any immediate complications and ensuring proper healing of the surgical site. Patients may be advised to follow specific guidelines regarding diet, activity level, and oral hygiene to promote recovery. Follow-up appointments are essential to assess the effectiveness of the procedure and to monitor for any potential issues related to the sutures or the surgical site. Patients should be informed about signs of infection or complications that may require medical attention.