Modified barbed soft palatal posterior pillar webbing flap palatopharyngoplasty

Abstract

Background

The soft palate and the lateral pharyngeal walls contribute to the collapse of the upper airway in patients with snoring and obstructive sleep apnea. In this study, the original soft palatal webbing flap palatopharyngoplasty for both soft palatal and oropharyngeal lateral wall collapse has been modified to include all tonsil grades and to apply the barbed suture technique.

Methods

Twenty-one adults with significant soft palatal webbing, lateral pharyngeal wall collapse, and tonsil hypertrophy of any grade were selected for the study with a minimum follow-up period of 6 months.

Results

Snoring was improved with snoring scale reduced from 9.4 ± 1.6 to 1.7 ± 3.2 (p < 0.005). The preoperative to postoperative apnea-hypopnea index (AHI) statistically improved from 45.7 ± 2.6 to 12.3 ± 3.9 (p < 0.005) and lowest O₂ saturation from 73.8 ± 3.6 to 89.4 ± 1.9 % (p < 0.005). Postoperative endoscopic findings showed significant improvement in soft palatal and lateral pharyngeal wall collapse. There were no significant intraoperative or postoperative complications.

Conclusion

Modified barbed soft palatal webbing flap palatopharyngoplasty provided objective improvement of obstructive sleep apnea (OSA) in adults with soft palatal, lateral pharyngeal wall collapse and tonsillar hypertrophy, with no significant complications and has the potential to serve as an effective alternative for these cases.

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