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European Archives of Oto-Rhino-Laryngology

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01-06-2019 | Sleep Apnea | Miscellaneous

Barbed suspension pharyngoplasty for treatment of lateral pharyngeal wall and palatal collapse in patients affected by OSAHS

Authors: Marco Barbieri, Francesco Missale, Fabiola Incandela, Marco Fragale, Andrea Barbieri, Valeria Roustan, Frank Rikki Canevari, Giorgio Peretti

Published in: European Archives of Oto-Rhino-Laryngology | Issue 6/2019

Abstract

Purpose

The aim of this study is to analyze the efficacy of a new modified pharyngoplasty technique with barbed sutures: barbed suspension pharyngoplasty (BSP).

Methods

We enrolled patients affected by obstructive sleep apnea–hypopnea syndrome (OSAHS), having the main site of obstruction at the palatal and lateral pharyngeal walls, who refused or failed to tolerate CPAP therapy and underwent non-resective pharyngoplasty with barbed sutures between January 2014 and October 2017. Two surgical techniques with barbed sutures were used: barbed reposition pharyngoplasty (BRP) and BSP; the main characteristics of the latter are a double passage of the needle, each side, through the soft palate.

Results

Forty-two patients met the study inclusion criteria and were included in the analysis. Twenty-two patients underwent BRP and 20 BSP. Patients treated with both BRP and BSP achieved significant improvement in polysomnographic parameters: AHI, ODI, t90%, and daily sleepiness tested by the ESS questionnaire (p < 0.001). There were no significant differences between groups considering gender, age, or severity of OSAHS (p > 0.05). Outcomes were also comparable (p = 0.10) in the two groups; patients who underwent BSP had successful treatment in 100% of cases, compared to 86% with BRP, with a cure rate of 40% vs. 18%.

Conclusions

BSP is a novel surgical technique that is effective in treating oropharyngeal collapse and can be tailored for patients with high collapsibility of the soft palate who might benefit from the palatal stiffness given by multiple passages of the suture inside it.

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Title: Barbed suspension pharyngoplasty for treatment of lateral pharyngeal wall and palatal collapse in patients affected by OSAHS
Authors: Marco Barbieri
Francesco Missale
Fabiola Incandela
Marco Fragale
Andrea Barbieri
Valeria Roustan
Frank Rikki Canevari
Giorgio Peretti
Publication date: 01-06-2019
Publisher: Springer Berlin Heidelberg
Keywords: Sleep Apnea
Pharyngoplasty
Published in: European Archives of Oto-Rhino-Laryngology / Issue 6/2019
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-019-05426-4

At a glance: The STEP trials

Springer Medicine

Barbed suspension pharyngoplasty for treatment of lateral pharyngeal wall and palatal collapse in patients affected by OSAHS

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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