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Pinto JA, Godoy LBMD, Nunes HDSS, Abdo KE, Jahic GS, Cavallini AF, Freitas GS, Ribeiro DK, Duarte C. Lateral-Expansion Pharyngoplasty: Combined Technique for the Treatment of Obstructive Sleep Apnea Syndrome. Int Arch Otorhinolaryngol 2019; 24:e107-e111. [PMID: 31892966 PMCID: PMC6828559 DOI: 10.1055/s-0039-1695026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 06/19/2019] [Indexed: 11/20/2022] Open
Abstract
Introduction
Obstructive sleep apnea syndrome (OSAS) is a multifactorial disease characterized by episodes of partial or complete collapse during sleep of different regions of the upper airway. Surgery for OSAS evolved with the introduction of different techniques, considering new surgical concept of reconstruction of the upper airway.
Objective
To retrospectively evaluate the effectiveness of a new approach aimed at reducing pharyngeal collapse by combining two surgical techniques: lateral and expansion pharyngoplasty.
Methods
We reviewed the medical records of 38 patients with OSAS undergoing lateral/expansion pharyngoplasty from January 2012 to December 2016. The following data were collected: patient age, gender, and pre- and postoperative body mass index (BMI), Epworth sleepiness scale (ESS) scores, snoring visual analogue scale (VAS) scores, and polysomnography (PSG) results.
Results
The PSG results showed a significant reduction in the apnea/hypopnea index (AHI) from 22.4 ± 27.3 events/h preoperatively to 13.6 ± 17.9 events/h postoperatively (
p
= 0.009), with postoperative AHI reduction greater than 50% in 63.2% of the patients. There was also a significant reduction in the microarousal index (19.5 ± 22.6 vs 11.0 ± 13.4 events/h;
p
= 0.001) and in the minimum oxygen saturation (82.6 ± 10.3 vs 86.9 ± 11.1;
p
= 0.007).
Conclusions
Lateral-expansion pharyngoplasty represents a new surgical strategy for the treatment of OSAS in patients with palatal collapse by combining two different techniques: lateral and expansion pharyngoplasty. The two techniques, performed as a one-stage procedure, led to improvements in excessive daytime sleepiness, snoring, and PSG respiratory parameters by acting on lateral and retropalatal collapse, producing favorable results with good applicability in otolaryngology clinical practice.
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Affiliation(s)
- José Antonio Pinto
- Director of Department of Otolaryngology, Núcleo de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço de São Paulo, São Paulo, SP, Brazil
| | - Luciana Balester Mello de Godoy
- Department of Otolaryngology, Núcleo de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço de São Paulo, São Paulo, SP, Brazil
| | - Heloisa Dos Santos Sobreira Nunes
- Department of Otolaryngology, Núcleo de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço de São Paulo, São Paulo, SP, Brazil.,Department of Otorhinolaryngology, Hospital Sao Camilo Pompeia, São Paulo, SP, Brazil
| | - Kelly Elia Abdo
- Department of Otolaryngology, Núcleo de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço de São Paulo, São Paulo, SP, Brazil.,Department of Otorhinolaryngology, Hospital Sao Camilo Pompeia, São Paulo, SP, Brazil
| | - Gabriella Spinola Jahic
- Department of Otolaryngology, Núcleo de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço de São Paulo, São Paulo, SP, Brazil.,Department of Otorhinolaryngology, Hospital Sao Camilo Pompeia, São Paulo, SP, Brazil
| | - André Freitas Cavallini
- Department of Otolaryngology, Núcleo de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço de São Paulo, São Paulo, SP, Brazil.,Department of Otorhinolaryngology, Hospital Sao Camilo Pompeia, São Paulo, SP, Brazil
| | - Gabriel Santos Freitas
- Department of Otolaryngology, Núcleo de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço de São Paulo, São Paulo, SP, Brazil.,Department of Otorhinolaryngology, Hospital Sao Camilo Pompeia, São Paulo, SP, Brazil
| | - Davi Knoll Ribeiro
- Department of Otolaryngology, Núcleo de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço de São Paulo, São Paulo, SP, Brazil.,Department of Otorhinolaryngology, Hospital Sao Camilo Pompeia, São Paulo, SP, Brazil
| | - Caue Duarte
- Department of Otolaryngology, Núcleo de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço de São Paulo, São Paulo, SP, Brazil.,Department of Otorhinolaryngology, Hospital Sao Camilo Pompeia, São Paulo, SP, Brazil
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