Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-18T08:12:48.036Z Has data issue: false hasContentIssue false
  • English
  • Français

Technical update of barbed pharyngoplasty for retropalatal obstruction in obstructive sleep apnoea

Published online by Cambridge University Press:  10 July 2019

M A Babademez ,
F Gul ,
H Kale  and
M Sancak
M A Babademez
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Yıldırım Beyazıt University School of Medicine, Ankara, Turkey
F Gul*
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Yıldırım Beyazıt University School of Medicine, Ankara, Turkey
H Kale
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Sami Ulus Training and Research Hospital, Ankara, Turkey
M Sancak
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Yıldırım Beyazıt University School of Medicine, Ankara, Turkey
*
Author for correspondence: Dr Fatih Gul, Department of Otorhinolaryngology, Head and Neck Surgery, Yıldırım Beyazıt University School of Medicine, Ankara, Turkey E-mail: [email protected] Fax: +90 3122 912 786
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Barbed pharyngoplasty aims to reduce lateral retropalatal obstruction by pulling up the soft palate anterolaterally. However, barbed pharyngoplasty can be less efficient in some cases of obstructive sleep apnoea, especially in the presence of an elongated uvula with redundant tissues over it. This paper describes an attempt to overcome this drawback by modifying barbed pharyngoplasty, using a single continuous suture technique.

Methods

Thirty-four patients were assigned to two groups based on the surgical procedure performed. Those with an elongated uvula were treated with modified barbed pharyngoplasty (n = 17); the others were treated with barbed pharyngoplasty (n = 17). Pre- and post-operative quality of life questionnaires, and questionnaires concerning diet, pain and return to activity, were completed. Pre- and post-operative polysomnography was performed as an objective measurement.

Results

There was no significant difference between barbed pharyngoplasty and modified barbed pharyngoplasty in terms of outcomes. However, reductions in the apnoea/hypopnea index, Epworth Sleepiness Scale and snoring visual analogue scale scores were greater in the modified barbed pharyngoplasty group.

Conclusion

Modified barbed pharyngoplasty is a safe and feasible method, and eliminates the need for surgical resection of the redundant soft tissues around the uvula while lifting up the uvula base.

Keywords

Obstructive Sleep ApneaSurgeryPharynx
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 7 , July 2019 , pp. 622 - 626
Copyright
Copyright © JLO (1984) Limited, 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr F Gul takes responsibility for the integrity of the content of the paper

References

1Kezirian, EJ, Weaver, EM, Yueh, B, Deyo, RA, Khuri, SF, Daley, J et al. Incidence of serious complications after uvulopalatopharyngoplasty. Laryngoscope 2004;114:450–3Google Scholar
2Kezirian, EJ, Weaver, EM, Yueh, B, Khuri, SF, Daley, J, Henderson, WG. Risk factors for serious complication after uvulopalatopharyngoplasty. Arch Otolaryngol Head Neck Surg 2006;132:1091–8Google Scholar
3Vicini, C, Hendawy, E, Campanini, A, Eesa, M, Bahgat, A, AlGhamdi, S et al. Barbed reposition pharyngoplasty (BRP) for OSAHS: a feasibility, safety, efficacy and teachability pilot study. “We are on the giant's shoulders”. Eur Arch Otorhinolaryngol 2015;272:3065–7010.1007/s00405-015-3628-3Google Scholar
4Fairbanks, DN. Uvulopalatopharyngoplasty complications and avoidance strategies. Otolaryngol Head Neck Surg 1990;102:239–45Google Scholar
5Powell, N, Riley, R, Guilleminault, C, Troell, R. A reversible uvulopalatal flap for snoring and sleep apnea syndrome. Sleep 1996;19:593–9Google Scholar
6Friedman, M, Ibrahim, HZ, Vidvasagar, R, Pomeranz, J. Z-palatoplasty (ZPP): a technique for patients without tonsils. Otolaryngol Head Neck Surg 2004;131:89–100Google Scholar
7Sorrenti, G, Pelligra, I, Albertini, R, Caccamo, G, Piccin, O. Functional expansion pharyngoplasty: technical update by unidirectional barbed sutures. Clin Otolaryngol 2018;43:1419–21Google Scholar
8Hur, J. A new treatment for snoring: sling snoreplasty with a permanent thread. Acta Otolaryngol 2008;128:1381–4Google Scholar
9Mantovani, M, Minetti, A, Torretta, S, Pincherle, A, Tassone, G, Pignataro, L. The velo-uvulo-pharyngeal lift or “roman blinds” technique for treatment of snoring: a preliminary report. Acta Otorhinolaryngol Ital 2012;32:48–53Google Scholar
10Li, HY, Li, KK, Chen, NH, Wang, PC. Modified uvulopalatopharyngoplasty: the extended uvulopalatal flap. Am J Otolaryngol 2003;24:311–16Google Scholar