Expansion sphincter pharyngoplasty: a new technique for the treatment of obstructive sleep apnea

• Published in: Otolaryngology-head and neck surgery Vol. 137; no. 1; p. 110
• Main Authors: Pang, Kenny P, Woodson, B Tucker
• Format: Journal Article
• Language: English
• Published: England 01.07.2007
• Subjects: Adult; Body Mass Index; Endoscopy; Female; Follow-Up Studies; Humans; Male; Middle Aged; Oxygen - blood; Palatal Muscles - surgery; Pharyngeal Muscles - physiopathology; Pharyngeal Muscles - surgery; Prospective Studies; Sleep Apnea, Obstructive - classification; Sleep Apnea, Obstructive - surgery; Suture Techniques; Tonsillectomy; Treatment Outcome; Uvula - surgery
• ISSN: 0194-5998
• DOI: 10.1016/j.otohns.2007.03.014

In this study, we assessed the efficacy of a new method (expansion sphincter pharyngoplasty [ESP]) to treat obstructive sleep apnea. We conducted a prospective, randomized controlled trial. Forty-five adults with small tonsils, body mass index less than 30 kg/m2, of Friedman stage II or III, of type I Fujita, and with lateral pharyngeal wall collapse were selected for the study. The mean body mass index was 28.7 kg/m2. The apnea-hypopnea index improved from 44.2 +/- 10.2 to 12.0 +/- 6.6 (P < 0.005) following ESP and from 38.1 +/- 6.46 to 19.6 +/- 7.9 in the uvulopalatopharyngoplasty group (P < 0.005). Lowest oxygen saturation improved from 78.4 +/- 8.52% to 85.2 +/- 5.1% in the ESP group (P = 0.003) and from 75.1 +/- 5.9% to 86.6 +/- 2.2% in the uvulopalatopharyngoplasty group (P < 0.005). Selecting a threshold of a 50% reduction in apnea-hypopnea index and apnea-hypopnea index less than 20, success was 82.6% in ESP compared with 68.1% in uvulopalatopharyngoplasty (P < 0.05). The ESP may offer benefits in a selected group of OSA patients.