Multi Level Single Stage: Barbed Reposition Pharyngoplasty and Nasal Surgery in Treatment of OSA—Our Experience

Pandey, Shailesh; Ghaisas, Virendra

doi:10.1007/s12070-019-01694-y

Cited by 19 publications

(16 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The role of BRP was confirmed by Montevecchi et al [10] in a prospective multicentric study published in 2017 and by Madkikar et al [11] in a subsequent prospective study. In both studies, BRP proved to be a simple, easy to learn, and safe procedure with promising results in the management of OSA and in single and multilevel surgery.…”

Section: Introductionmentioning

confidence: 77%

Long-Term Subjective Outcomes of Barbed Reposition Pharyngoplasty for Obstructive Sleep Apnea Syndrome Treatment

Iannella

Vallicelli

Magliulo

et al. 2020

IJERPH

View full text Add to dashboard Cite

Background: The purpose of this study was to evaluate long-term subjective outcomes of barbed reposition pharyngoplasty for obstructive sleep apnea syndrome (OSAS) treatment using a specific questionnaire, the Palate Postoperative Problem Score (PPOPS). Methods: 140 patients who underwent barbed reposition pharyngoplasty (BRP) surgery in the Morgagni Pierantoni Hospital of Forlì, Italy were enrolled in the study. Postoperative outcomes were evaluated in a short- and long-term follow-up using the PPOPS questionnaire. The average period of follow-up was 26 months. All patients received the PPOPS questionnaire by telephone in a period between April and August 2019. Results: 51% of patients complained of swallowing problems after surgery. In 91% of cases, the problem cleared up spontaneously. At the time of the interview, only 9% of patients had a residual swallowing difficult. At the time of PPOPS evaluation, rhinolalia was observed in 8% of patients, whereas nose regurgitation was present in 2% of patients. In 20% of patients, the foreign body sensation was present during follow-up. The value of apnea–hypopnea index (AHI) reduced from the preoperative value of 31.5 to the postoperative value of 11.4. Conclusions: BRP surgery proved to be an effective technique, appreciated by the majority of patients. Use of the PPOPS questionnaire has demonstrated that the BRP technique seems to ensure efficacy and lower morbidity, with few complications after surgery.

show abstract

Section: Introductionmentioning

confidence: 77%

Long-Term Subjective Outcomes of Barbed Reposition Pharyngoplasty for Obstructive Sleep Apnea Syndrome Treatment

Iannella

Vallicelli

Magliulo

et al. 2020

IJERPH

View full text Add to dashboard Cite

show abstract

“…A series of sutures enlarge the oropharyngeal isthmus laterally and rearrange anteriorly the lateral insertion of the soft palate to increase the retropalatal airway. [37][38][39][40] Both ESP and BRP resulted in a better change in AHI and a greater surgical success rate in comparison with UPPP. 20,21,41 Many studies have shown that both procedures are cost-effective therapy as well as safe and effective in the long-term follow-up.…”

Section: Discussionmentioning

confidence: 99%

Barbed Reposition Pharyngoplasty versus Expansion Sphincter Pharyngoplasty: A Meta‐Analysis

2020

View full text Add to dashboard Cite

This study was to compare barbed reposition pharyngoplasty (BRP) and expansion sphincter pharyngoplasty (ESP) in the treatment of obstructive sleep apnea (OSA).Methods: Relevant 907 articles were searched from various databases until August 2020, including PubMed, MEDLINE, EMBASE, Cochrane Library, Web of Science and Scopus, and reference lists.Results: Four studies with a total of 208 participants were included. The mean reduction of apnea-hypopnea index (AHI) in the BRP group was 74.03% and the mean reduction of AHI in the ESP group was 60.17%. The mean success rate in the BRP group and the ESP group was 84.96% and 79.87%, respectively. The mean difference (MD) of the change in AHI between groups was not significantly different (MD = −1.24 event/hr, 95% CI [−11.86, 9.36], P = .82). There was no significant difference in postoperative AHI, postoperative Epworth Sleepiness Scale, pain, hospital stay, time to oral diet, and the change in oxygen desaturation index in both groups whereas the analgesic requirement was lower in the BRP group. Operative time was lower in the BRP group (MD = 21.72 minutes, 95% CI [18.85,24.60], P < .0001). Conclusion:The outcomes in both procedures are comparable in the improvement of OSA with palatal collapse. BRP is superior to ESP in term of surgical time. However, randomized clinical controlled trials with multicenter cooperation and longterm follow-up are essential to further demonstrate the efficacy of these procedures.

show abstract

“…Nowadays obesity is widely recognised as the most important risk factor for OSAHS: a 10% weight gain increases the risk of developing this disease by six-times 20 and according to recent estimates more than half of obese people are affected by OSAHS 4 . Particularly at risk are people affected by central or visceral obesity, with prevalent fat deposition in the trunk and neck area, also known as android obesity, because typically male 21 .…”

Section: The Interactions Between Osahs and Obesitymentioning

confidence: 99%

“…However, it is important to start using the device gradually, increasing the time of use day by day. At the end of the gradual MAD adjustment period, which can take from 3 to 5 months, a new polysomnography should be performed to quantify the obtained gains 20 . Although less effective than CPAP, MAD have given positive results in the treatment of OSAHS 90 , although limited to the moment in which patient is using the device 20 , which are preferentially indicated for mild or moderate OSAHS 91 .…”

Section: Mandibular Advancement Devices (Mad)mentioning

confidence: 99%

“…Surgical options include several procedures, with different degrees of invasiveness, with the aim to remove respiratory obstructive factors in the anatomical districts of ENT interest 1 : in over 75% of cases, however, these interventions are directed to the nose, palate and lateral walls of the pharynx and, among them, the most popular procedures are uvulopalatopharyngoplasty (UPPP) and lateral pharyngoplasty techniques 94 . On the other hand, soft tissue modifications can also be obtained by maxillofacial skeletal surgery, and more specifically maxillomandibular orthognathic surgery 20 . Uvulopalatopharyngoplasty involves resection of the tonsils (if present), uvula, and posterior palate and reorientation of the tonsillar pillars, eventually with the help of harmonic scalpel 95 or other devices to remove redundant mucosa and to create a neouvula.…”

Section: Surgerymentioning

confidence: 99%

See 1 more Smart Citation

Obstructive sleep apnoea/hypopnoea syndrome: relationship with obesity and management in obese patients

Salzano

Maglitto

Bisogno

et al. 2021

Acta Otorhinolaryngol Ital

View full text Add to dashboard Cite

Obstructive sleep apnoea/hypopnoea syndrome (OSAHS) is a disease characterised by upper airway obstruction during sleep, quite frequent in the general population, even if underestimated. Snoring, sleep apnoea and diurnal hypersomnia are common in these patients. Central obesity plays a key role: it reduces the size and changes the conformation of the upper airways, besides preventing lung expansion, with consequent reduction of lung volumes. Furthermore, obese people are also resistant to leptin, which physiologically stimulates ventilation; as a result, this causes scarce awakening during apnoea. OSAHS diagnosis is based on the combination of clinical parameters, such as apnoea/hypopnoea index (AHI), medical history, physical examination and Mallampati score. The first objective reference method to identify OSAHS is polysomnography followed by sleep endoscopy. Therapy provides in the first instance reduction of body weight, followed by continuous positive airway pressure (CPAP), which still remains the treatment of choice in most patients, mandibular advancement devices (MAD) and finally otolaryngology or maxillofacial surgery. Among surgical techniques, central is barbed reposition pharyngoplasty (BRP), used in the field of multilevel surgery.

show abstract

Multi Level Single Stage: Barbed Reposition Pharyngoplasty and Nasal Surgery in Treatment of OSA—Our Experience

Cited by 19 publications

References 8 publications

Long-Term Subjective Outcomes of Barbed Reposition Pharyngoplasty for Obstructive Sleep Apnea Syndrome Treatment

Long-Term Subjective Outcomes of Barbed Reposition Pharyngoplasty for Obstructive Sleep Apnea Syndrome Treatment

Barbed Reposition Pharyngoplasty versus Expansion Sphincter Pharyngoplasty: A Meta‐Analysis

Obstructive sleep apnoea/hypopnoea syndrome: relationship with obesity and management in obese patients

Contact Info

Product

Resources

About