Barbed suspension pharyngoplasty for treatment of lateral pharyngeal wall and palatal collapse in patients affected by OSAHS

Marco Barbieri, Francesco Missale, Fabiola Incandela, Marco Fragale, Andrea Barbieri, Valeria Roustan, Frank Rikki Canevari, Giorgio Peretti

Research output: Contribution to journalArticle

Abstract

Purpose: The aim of this study is to analyze the efficacy of a new modified pharyngoplasty technique with barbed sutures: barbed suspension pharyngoplasty (BSP). Methods: We enrolled patients affected by obstructive sleep apnea–hypopnea syndrome (OSAHS), having the main site of obstruction at the palatal and lateral pharyngeal walls, who refused or failed to tolerate CPAP therapy and underwent non-resective pharyngoplasty with barbed sutures between January 2014 and October 2017. Two surgical techniques with barbed sutures were used: barbed reposition pharyngoplasty (BRP) and BSP; the main characteristics of the latter are a double passage of the needle, each side, through the soft palate. Results: Forty-two patients met the study inclusion criteria and were included in the analysis. Twenty-two patients underwent BRP and 20 BSP. Patients treated with both BRP and BSP achieved significant improvement in polysomnographic parameters: AHI, ODI, t90%, and daily sleepiness tested by the ESS questionnaire (p < 0.001). There were no significant differences between groups considering gender, age, or severity of OSAHS (p > 0.05). Outcomes were also comparable (p = 0.10) in the two groups; patients who underwent BSP had successful treatment in 100% of cases, compared to 86% with BRP, with a cure rate of 40% vs. 18%. Conclusions: BSP is a novel surgical technique that is effective in treating oropharyngeal collapse and can be tailored for patients with high collapsibility of the soft palate who might benefit from the palatal stiffness given by multiple passages of the suture inside it.

Original languageEnglish
Pages (from-to)1829-1835
Number of pages7
JournalEuropean Archives of Oto-Rhino-Laryngology
Volume276
Issue number6
DOIs
Publication statusPublished - Jun 1 2019

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Suspensions
Sleep
Sutures
Soft Palate
Therapeutics
Needles

Keywords

  • Barbed
  • OSA
  • Outcome
  • Pharyngoplasty
  • Sleep apnea
  • Surgery

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Barbed suspension pharyngoplasty for treatment of lateral pharyngeal wall and palatal collapse in patients affected by OSAHS. / Barbieri, Marco; Missale, Francesco; Incandela, Fabiola; Fragale, Marco; Barbieri, Andrea; Roustan, Valeria; Canevari, Frank Rikki; Peretti, Giorgio.

In: European Archives of Oto-Rhino-Laryngology, Vol. 276, No. 6, 01.06.2019, p. 1829-1835.

Research output: Contribution to journalArticle

Barbieri, Marco ; Missale, Francesco ; Incandela, Fabiola ; Fragale, Marco ; Barbieri, Andrea ; Roustan, Valeria ; Canevari, Frank Rikki ; Peretti, Giorgio. / Barbed suspension pharyngoplasty for treatment of lateral pharyngeal wall and palatal collapse in patients affected by OSAHS. In: European Archives of Oto-Rhino-Laryngology. 2019 ; Vol. 276, No. 6. pp. 1829-1835.
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abstract = "Purpose: The aim of this study is to analyze the efficacy of a new modified pharyngoplasty technique with barbed sutures: barbed suspension pharyngoplasty (BSP). Methods: We enrolled patients affected by obstructive sleep apnea–hypopnea syndrome (OSAHS), having the main site of obstruction at the palatal and lateral pharyngeal walls, who refused or failed to tolerate CPAP therapy and underwent non-resective pharyngoplasty with barbed sutures between January 2014 and October 2017. Two surgical techniques with barbed sutures were used: barbed reposition pharyngoplasty (BRP) and BSP; the main characteristics of the latter are a double passage of the needle, each side, through the soft palate. Results: Forty-two patients met the study inclusion criteria and were included in the analysis. Twenty-two patients underwent BRP and 20 BSP. Patients treated with both BRP and BSP achieved significant improvement in polysomnographic parameters: AHI, ODI, t90{\%}, and daily sleepiness tested by the ESS questionnaire (p < 0.001). There were no significant differences between groups considering gender, age, or severity of OSAHS (p > 0.05). Outcomes were also comparable (p = 0.10) in the two groups; patients who underwent BSP had successful treatment in 100{\%} of cases, compared to 86{\%} with BRP, with a cure rate of 40{\%} vs. 18{\%}. Conclusions: BSP is a novel surgical technique that is effective in treating oropharyngeal collapse and can be tailored for patients with high collapsibility of the soft palate who might benefit from the palatal stiffness given by multiple passages of the suture inside it.",
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AU - Fragale, Marco

AU - Barbieri, Andrea

AU - Roustan, Valeria

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AU - Peretti, Giorgio

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