BACKGROUND: This first prospective study evaluates the efficacy and safety of single-port transoral robotic surgery (SP TORS) for tongue base resection (TBR) in obstructive sleep apnea (OSA) patients. METHODS: A single-center, single-surgeon clinical investigation enrolled 25 subjects from April 2021 to September 2022. Pre- and postsurgery polysomnography reports and standardized sleep quality assessments were collected. Surgical parameters and complications were documented. RESULTS: According to Sher's success criteria (50% reduction in AHI and AHI < 20), the success rate was 76% (19/25 patients). Preoperative AHI decreased from 58.56 +/- 26.40 to 18.19 +/- 22.02 postsurgery. Symptoms such as foreign body sensation and taste dysfunction improved within 3 months. Major complications, including hemorrhage, occurred in two patients (8%). CONCLUSIONS: SP TORS TBR effectively manages OSA, significantly improving AHI outcomes and safety. Its precision and targeted tissue removal highlight its advantages over traditional methods, warranting further clinical investigation. Traial Registration: ClinicalTrials.gov identifier: NCT04795817.
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