Functional expansion pharyngoplasty in the treatment of obstructive sleep apnea

Sorrenti, Giovanni; Piccin, Ottavio

doi:10.1002/lary.23911

Cited by 77 publications

(49 citation statements)

References 10 publications

(15 reference statements)

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“…The reported success rate was good (89.2 %) and the only significant postoperative complications were two cases of bleeding. Our experience is comparable with that of Sorrenti and Piccin in terms of the overall success rate and post-surgical reduction in the AHI and mean time with \90 % O 2 saturation, but the authors do not give any information about the tolerability of the procedure [21]. FEP can be considered an evolution of ESP as the relocated palatopharyngeal muscle is anchored to the pterygoid hamulus, which seems to us to be rationally more effective and durable than using a non-rigid suspension point such as soft palate muscles.…”

Section: Discussionsupporting

confidence: 86%

“…Associated with bilateral tonsillectomy, functional expansion pharyngoplasty (FEP) involves the splinting and partial transection of the palatopharyngeal muscle, which is rotated through a palatine tunnel ''that ideally reaches the pterygoid process and therefore the pterygomaxillary raphe'', and attached to the palatine musculature ''close to the pterygoid hamulus'' [21]. The reported success rate was good (89.2 %) and the only significant postoperative complications were two cases of bleeding.…”

Section: Discussionmentioning

confidence: 97%

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Barbed Roman blinds technique for the treatment of obstructive sleep apnea: how we do it?

Mantovani

Rinaldi

Torretta

et al. 2015

Eur Arch Otorhinolaryngol

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Retro-palatal obstruction is often involved in the pathogenesis of obstructive sleep apnea syndrome (OSAS), which is currently treated by means of various surgical procedures. The aim of this paper is to describe our preliminary results using a new, minimally invasive and non-resective procedure called the "barbed Roman blinds technique" (BRBT), which was used to treat severe OSAS due to retro-palatal obstruction. The apnea-hypopnea index (AHI), time with <90 % O2 saturation, and Epworth Sleepiness Scale (ESS) of 32 consecutive adult outpatients (mean age 47.3 ± 8.6 years) were compared before and after surgery. The tolerability of the procedure was assessed using a 0-10 visual analog scale (VAS). All of the treated patients experienced a clinical and subjective improvement as documented by the significant differences (P < 0.001) in their pre- and post-BRBT AHI, time with <90 % O2 saturation, and ESS scores. There were no minor or major adverse events, and the good tolerability of the procedure was documented by the short mean hospital stay (1.2 ± 0.5 days) and the mean VAS value of 4.3 ± 0.7. The mean follow-up period was 12.2 ± 2.0 months. The preliminary results indicate that the BRBT is safe and effective, but long-term follow-up and comparative studies of larger case series are needed to confirm these encouraging findings.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 97%

Barbed Roman blinds technique for the treatment of obstructive sleep apnea: how we do it?

Mantovani

Rinaldi

Torretta

et al. 2015

Eur Arch Otorhinolaryngol

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“…They demonstrated that the success rate of the modified expansion pharyngoplasty technique group for a post-operative AHI \ 5 was 80 %, while compared to traditional adeno-tonsillectomy group for a post-operative AHI \ 5 was only 60 % [14]. Sorrenti and Piccin [13] demonstrated in 85 patients with OSA, who had the functional expansion pharyngoplasty technique done, a reduction from pre-operative mean AHI 33.3 to post-operative mean AHI 11.7; and an encouraging success rate (with 50 % reduction of pre-operative AHI and AHI \ 20) of 89.2 %.…”

Section: Discussionmentioning

confidence: 99%

“…There have been some modifications of the expansion pharyngoplasty technique, namely the Functional Expansion Pharyngoplasty [13,14] and the Modified Expansion Pharyngoplasty [14], both being similar and fundamentally alike (with the crucial isolation of the palatopharyngeus muscle and its rotation antero-supero-laterally). Both techniques describe the use of a tunneling method of mobilizing the palatopharyngeus muscle antero-superolaterally through an incision made on the anterior surface of the soft palate, just medial to the last upper molar on their respective sides [13,14].…”

Section: Surgical Techniquementioning

confidence: 99%

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Combined Expansion Pharyngoplasty and Anterior Palatoplasty for the Treatment of OSA

Pang¹,

Piccin

Pang³

et al. 2016

Indian J Otolaryngol Head Neck Surg

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To evaluate the success rates of combined Expansion Sphincter Pharyngoplasty and the Anterior Palatoplasty in the treatment of OSA. A two center prospective series of 73 patients with OSA. All patients were [18 years old, retro-palatal obstruction, concentric velo-pharyngeal collapse, BMI \ 33, Friedman clinical stage II, with all grades of AHI. The procedure involved the anterior palatoplasty, tonsillectomy and expansion sphincter pharyngoplasty with or without nasal surgery. There were 68 men and 5 women, the mean age was 46.8 years old (range of 25-67 years), mean BMI was 25.5 (range of 20.3-31.2). All patients had pre-operative and post-operative PSG. The AHI improved in all patients, mean AHI improved from 26.3 ± 17.7 to 12.6 ± 5.8 (p \ 0.001). There were 20 mild OSA, 33 moderate OSA and 20 severe OSA patients. Twenty-three patients had preoperative DISE, and 61 patients had nose/palate surgery, while only 12 had palate surgery alone. The overall success rate (50 % reduction and AHI \ 20) was 86.3 %. The mean snore scores (VAS) improved from 8.8 ± 1.2 to 2.0 ± 1.3 (p \ 0.001). The mean Epworth score improved from 11.5 ± 2.2 to 2.9 ± 2.1 (p \ 0.001). Lowest oxygen saturation also improved in all patients. Subjectively, all the patients felt less tiredness. Pre-operative DISE assessment did not seem to confer any advantage over the patients who had no pre-operative DISE (p = 0.027), and patients who had nose/palate surgery seemed to have better success rates compared to those who only had palate surgery (p = 0.081). This combined technique has been shown to be effective in selected group of OSA patients. Level of evidence IV.

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Modified Expansion Sphincter Pharyngoplasty for Treatment of Children With Obstructive Sleep Apnea

Ulualp

2014

JAMA Otolaryngol Head Neck Surg

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Functional expansion pharyngoplasty in the treatment of obstructive sleep apnea

Cited by 77 publications

References 10 publications

Barbed Roman blinds technique for the treatment of obstructive sleep apnea: how we do it?

Barbed Roman blinds technique for the treatment of obstructive sleep apnea: how we do it?

Combined Expansion Pharyngoplasty and Anterior Palatoplasty for the Treatment of OSA

Modified Expansion Sphincter Pharyngoplasty for Treatment of Children With Obstructive Sleep Apnea

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