Faculty Collaboration Database

Transpalatal advancement pharyngoplasty for obstructive sleep apnea. Laryngoscope 1993 Mar;103(3):269-76

Date

03/01/1993

Pubmed ID

8441314

DOI

10.1288/00005537-199303000-00006

Scopus ID

2-s2.0-0027392809 (requires institutional sign-in at Scopus site)   83 Citations

Abstract

Uvulopalatopharyngoplasty (UPPP) is a commonly performed procedure for obstructive sleep apnea (OSA). However, results are inconsistent. Patients in whom the UPPP procedure has failed have a smaller change in airway size as compared to responders, and also many demonstrate continued obstruction at the palate. We present a modification, transpalatal advancement pharyngoplasty, that increases upper oropharyngeal and retropalatal airway size by advancing the soft palate. Eleven patients with severe OSA and multiple sites of airway narrowing were corrected by this method. Three patients had prior UPPP and 5 patients had concomitant tongue-base procedures. Overall results demonstrate clinical enlargement of the retropalatal space. In the 6 patients who had transpalatal advancement pharyngoplasty alone, 4 (67%) were successful responders as defined by a respiratory disturbance index (RDI) of less than 20 events per hour. RDI decreased from 52.8 +/- 12.2 to 12.3 +/- 2.8 events per hour. For the entire group, RDI decreased from 73.3 +/- 29.4 to 25.1 +/- 28.2 events per hour (P < .001). There were four complications, including a transient oronasal fistula(1), transient dysphagia(2), and serous otitis media(1). Transpalatal advancement pharyngoplasty potentially may offer an alternative to increasingly aggressive resection with UPPP in an effort to increase the upper oropharyngeal and retropalatal airway and may be appropriate in careful selected patients as part of the surgical treatment of OSA.

Author List

Woodson BT, Toohill RJ

Author

B Tucker Woodson MD Chief, Professor in the Otolaryngology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Electrocoagulation
Female
Humans
Male
Middle Aged
Mouth Mucosa
Oropharynx
Osteotomy
Palatal Muscles
Palate
Palate, Soft
Pharynx
Respiration
Sleep Apnea Syndromes
Surgical Flaps
Suture Techniques
Tongue
Tonsillectomy
Uvula