Expansion sphincter pharyngoplasty: analyzing the technique based on anatomy

2020 ◽  
Author(s):  
Ela Cömert ◽  
Ayhan Cömert ◽  
Ziya Şencan
Keyword(s):  
Expansion Sphincter Pharyngoplasty ◽  
Sphincter Pharyngoplasty

scholarly journals The Role of Modified Expansion Sphincter Pharyngoplasty in Multilevel Obstructive Sleep Apnea Syndrome Surgery

2018 ◽  
Vol 22 (04) ◽  
pp. 432-436 ◽  
Author(s):  
Francesco Lorusso ◽  
Francesco Dispenza ◽  
Domenico Modica ◽  
Salvatore Gallina
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Daytime Sleepiness ◽  
Sleep Apnea Syndrome ◽  
Upper Airway ◽  
Obstructive Sleep ◽  
Müller Maneuver ◽  
Expansion Sphincter Pharyngoplasty ◽  
Sphincter Pharyngoplasty ◽  
Apnea Syndrome

Introduction Obstructive sleep apnea syndrome (OSAS) is a sleep disorder caused by an excessive narrowing of the pharyngeal airway that also collapses during inspiration, with an important role played by the lateral pharyngeal wall in the development of the obstruction. Objective To describe our surgical experience with modified expansion sphincter pharyngoplasty (MESP) in the management of lateral collapse in upper airway multilevel surgery. Methods A total of 20 patients with moderate to severe OSAS were recruited in the Ear, Nose and Throat (ENT) Department of the University of Palermo, Italy. All of the enrolled patients refused the ventilatory therapy. The subjects were evaluated for snoring, and daytime sleepiness had a clinical evaluation including collection of anthropometric data and ENT examination and rhinofibroscopy with Müller maneuver. The patients undergoing upper airway multilevel surgery and we selected for MESP the patients with an oropharyngeal transverse pattern of collapse at Müller maneuver. Results In the postoperative assessment, all of the patients reported a reduction in snoring scores and daytime sleepiness. We observed a reduction in the mean apnea-hypopnea index (AHI) of 57.5% of the sample, which decreased from a mean value of 41.7 ( ± 21.5) to 17.4 ( ±  8.9) (p < 0.05), with a success rate, according to the Sher criteria, of 65%. We observed very few postoperative complications. Conclusion Modified expansion sphincter pharyngoplasty in multilevel surgical therapy preceded by a careful selection of patients has proven to be effective in treating patients with moderate to severe syndromes.

Expansion Sphincter Pharyngoplasty: A New Technique for the Treatment of Obstructive Sleep Apnea

2007 ◽  
Vol 137 (1) ◽  
pp. 110-114 ◽  
Author(s):  
Kenny P. Pang ◽  
B. Tucker Woodson
Keyword(s):  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Body Mass ◽  
Apnea Hypopnea Index ◽  
Type I ◽  
Pharyngeal Wall ◽  
Obstructive Sleep ◽  
Expansion Sphincter Pharyngoplasty ◽  
Sphincter Pharyngoplasty

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/m 2 , 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/m 2 . 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.

Expansion sphincter pharyngoplasty for the treatment of OSA: a systemic review and meta-analysis

2015 ◽  
Vol 273 (9) ◽  
pp. 2329-2333 ◽  
Author(s):  
Kenny P. Pang ◽  
Edward B. Pang ◽  
Ma Thin Mar Win ◽  
Kathleen A. Pang ◽  
B. Tucker Woodson
Keyword(s):  
Meta Analysis ◽  
Systemic Review ◽  
Expansion Sphincter Pharyngoplasty ◽  
Sphincter Pharyngoplasty

Comparing Upper Airway Stimulation to Expansion Sphincter Pharyngoplasty: A Single University Experience

2018 ◽  
Vol 127 (6) ◽  
pp. 379-383 ◽  
Author(s):  
Colin Huntley ◽  
David W. Chou ◽  
Karl Doghramji ◽  
Maurits Boon
Keyword(s):  
Success Rate ◽  
Upper Airway ◽  
Upper Airway Stimulation ◽  
Surgical Success ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Expansion Sphincter Pharyngoplasty ◽  
The Mean ◽  
Sphincter Pharyngoplasty ◽  
Surgical Option

Introduction: Expansion sphincter pharyngoplasty (ESP) is a surgical option for patients with obstructive sleep apnea (OSA). Upper airway stimulation (UAS) is an alternative that has shown success in initial outcomes studies. We compare outcomes of a cohort of patients undergoing UAS to ESP. Methods: We compared demographic and polysomnographic data of the UAS to ESP cohorts. We also calculated the proportion of patients achieving surgical success. Results: The ESP cohort consisted of 33 patients. The mean preoperative Apnea-Hypopnea Index (AHI), O2 nadir, Epworth Sleepiness Scale (ESS), and BMI were 36.47 ± 20.01, 82.63 ± 5.37, 10.69 ± 4.42, and 29.6 ± 4.49, which improved to 13.47 ± 18.74, 84.84 ± 5.48, 7.00 ± 5.81, and 29.92 ± 4.59 postoperatively. There was a 63.64% success rate. The UAS cohort consisted of 75 patients. The mean preoperative AHI, O2 nadir, ESS, and BMI were 36.76 ± 20.72, 80.24 ± 8.43, 11.18 ± 4.16, and 29.50 ± 3.96, which improved to 7.25 ± 11.19, 88.71 ± 3.25, 5.36 ± 3.35, and 29.36 ± 3.68 postoperatively. The success rate was 86.67%. We found a significant difference in gender, age, preoperative AHI, postoperative AHI, postoperative O2 nadir, surgical success, and patients reaching an AHI less than 10 and 5. Conclusion: Upper airway stimulation is a new surgical option for select patients with OSA showing comparable or improved outcomes to a cohort of patients undergoing ESP.

scholarly journals Eustachian tube dysfunction in candidates for surgery for obstructive sleep apnoea syndrome

2020 ◽  
Vol 134 (1) ◽  
pp. 81-85
Author(s):  
O J Ungar ◽  
E Rosenzweig ◽  
H Rotem Betito ◽  
O Cavel ◽  
Y Oron ◽  
...  
Keyword(s):  
Eustachian Tube ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Eustachian Tube Dysfunction ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Sleep Apnoea Syndrome ◽  
Obstructive Sleep ◽  
Tube Dysfunction ◽  
Expansion Sphincter Pharyngoplasty ◽  
Sphincter Pharyngoplasty

AbstractBackgroundDefining the risk factors for Eustachian tube dysfunction can facilitate its prevention. It is hypothesised that Eustachian tube dysfunction as measured by the Eustachian Tube Dysfunction Questionnaire-7 is associated with obstructive sleep apnoea syndrome.MethodsThe questionnaire was systematically translated into Hebrew and validated in the accepted manner. This questionnaire was applied to obstructive sleep apnoea syndrome patients before and after expansion sphincter pharyngoplasty, in pre-set time intervals. The results were compared to those of controls from the general population.ResultsThirty-one patients (males:females = 19:12) were enrolled in the obstructive sleep apnoea syndrome group. Mean age was 43 years (range, 31–55 years) and mean body mass index was 28 kg/m2 (range, 27–30 kg/m2). Median apnoea-hypopnea index (pre-operatively) was 34 events per hour. The questionnaire scores in expansion sphincter pharyngoplasty candidates were significantly worse than in controls (p < 0.001). Expansion sphincter pharyngoplasty did not change Eustachian tube function in the long term, but was associated with additional self-limiting Eustachian tube dysfunction in the first two post-operative months.ConclusionEustachian tube dysfunction is significantly worse in patients with obstructive sleep apnoea syndrome compared to controls. Expansion sphincter pharyngoplasty is not associated with Eustachian tube function improvement.

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