Expansion sphincter pharyngoplasty: Usefulness of DISE

The aim of this study was first to present the indications and results using expansion sphincter pharyngoplasty to treat obstructive sleep apnoea-hypopnoea syndrome (OSAHS). And second, to compare the findings of drug-induced sleep endoscopy (DISE) before and after the surgery. The study design was...

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Bibliographic Details
Published in:Acta otorrinolaringológica española (English) 2019-07, Vol.70 (4), p.215-221
Main Authors: Bosco, Gabriela, Pérez-Martín, Nuria, Racionero, Miguel A, Plaza, Guillermo
Format: Article
Language:English
Subjects:
Adult
Airway Obstruction - surgery
Endoscopy - methods
Female
Humans
Male
Middle Aged
Palate, Soft - surgery
Pharyngeal Muscles - surgery
Pharynx - surgery
Polysomnography
Prospective Studies
Sleep - drug effects
Sleep Aids, Pharmaceutical - pharmacology
Sleep Apnea, Obstructive - surgery
Suture Techniques
Treatment Outcome
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Summary:The aim of this study was first to present the indications and results using expansion sphincter pharyngoplasty to treat obstructive sleep apnoea-hypopnoea syndrome (OSAHS). And second, to compare the findings of drug-induced sleep endoscopy (DISE) before and after the surgery. The study design was a prospective cohort of patients surgically treated between 2015 and 2016. All patients were diagnosed with mild to severe obstructive sleep apnoea and did not tolerate CPAP. All had pre- and post-surgery DISE and polysomnography. The inclusion criteria were age, between 18 years and 70 years, small tonsils (sizes 1 and 2), Friedman II and III clinical stage, and lateral collapse in preoperative DISE. We performed surgery to the palate only, using expansion sphincter pharyngoplasty. Seventeen patients were included, 52.94% had severe OSAHS. Average age was 42 years, average body mass index was 28. The surgical success rate according to Sher criteria was 82.35%. 41.17% had a postoperative apnoea-hypopnoea index of less than 10. Seventy-five percent of the patients had no further need for CPAP. Expansion sphincter pharyngoplasty is a safe technique for treating OSAHS, in patients with small tonsils, Friedman grade I and II and collapse of lateral walls in DISE, in the absence of multilevel collapse. The postoperative DISE showed improvement of the lateral collapse was achieved with the expansion.
ISSN:2173-5735
2173-5735
DOI:10.1016/j.otoeng.2019.06.002