Lateral pharyngoplasty vs. traditional uvulopalatopharyngoplasty for patients with OSA: systematic review and meta-analysis

• Published in: Sleep & breathing Vol. 26; no. 4; pp. 1539 - 1550
• Main Authors: Maniaci, Antonino, Di Luca, Milena, Lechien, Jerome René, Iannella, Giannicola, Grillo, Calogero, Grillo, Caterina Maria, Merlino, Federico, Calvo-Henriquez, Christian, De Vito, Andrea, Magliulo, Giuseppe, Pace, Annalisa, Vicini, Claudio, Cocuzza, Salvatore, Bannò, Vittoria, Pollicina, Isabella, Stilo, Giovanna, Bianchi, Alberto, La Mantia, Ignazio
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.12.2022; Springer Nature B.V
• Subjects: Apnea; Dentistry; Internal Medicine; Literature reviews; Medicine; Medicine & Public Health; Meta-analysis; Neurology; Otorhinolaryngology; Patients; Pediatrics; Pneumology/Respiratory System; Sleep and wakefulness; Sleep apnea; Sleep Breathing Physiology and Disorders • Review; Sleep disorders; Systematic review; Expansion sphincter pharyngoplasty; OSA surgery; Barbed reposition pharyngoplasty; Obstructive sleep apnea; Uvulopalatopharyngoplasty
• ISSN: 1520-9512; 1522-1709
• DOI: 10.1007/s11325-021-02520-y

Objectives To compare the efficacy and success rates of lateral pharyngoplasty techniques (LP) vs. uvulopalatopharyngoplasty (UPPP) among adult patients surgically treated for obstructive sleep apnea. Methods A systematic literature review of the last 20 years’ papers was conducted using PubMed/Medline, Embase, Web of Science, Scholar, and the Cochrane Library until April 2021. Only full-text English articles comparing LP and UPPP outcomes in adult patients with objective outcomes were included in the study. Results We included 9 articles for a total of 312 surgically treated patients with OSA. LP techniques for obstructive sleep apnea were used on 186 (60%) subjects, while 126 patients (40%) were treated with UPPP. Both surgical procedures resulted in significant improvements in apnea-hypopnea index (AHI), Epworth Sleepiness Scale (ESS) score, and lowest oxygen saturation (LOS) ( p  < 0.001 in all cases). Although better outcomes were reported with lateral pharyngoplasty, the differences were not significant compared to UPPP post-operative results ( p  > 0.05 in all cases). Conclusions UPPP and LP are both effective surgical procedures in treating OSA in adults. Although not significant, LPs demonstrated improved post-operative outcomes. However, further evidence comparing the surgical effect on patients with OSA is needed to discriminate post-operative outcomes.