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

Otolaryngol Head Neck Surg. 2007 Jul;137(1):110-4. doi: 10.1016/j.otohns.2007.03.014.

Abstract

Objective: In this study, we assessed the efficacy of a new method (expansion sphincter pharyngoplasty [ESP]) to treat obstructive sleep apnea.

Study design: We conducted a prospective, randomized controlled trial.

Methods: 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.

Results: 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).

Conclusion/significance: The ESP may offer benefits in a selected group of OSA patients.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • 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

Substances

  • Oxygen