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

doi:10.1007/s00405-019-05426-4

Cited by 32 publications

(13 citation statements)

References 16 publications

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“…Barbed reposition pharyngoplasty has had the same effect as expansion sphincter pharyngoplasty combined with anterior palatoplasty in terms of enlarging both the lateral and anteroposterior direction of retropalatal space in the study by Babademez et al [ 41 ]. Barbed suspension pharyngoplasty was shown in a 2019 study by Barbieri et al, and the study compared barbed reposition pharyngoplasty and barbed suspension pharyngoplasty [ 42 ]. Both surgeries had the same excellent result.…”

Section: Discussionmentioning

confidence: 99%

“…Both surgeries had the same excellent result. The BRP was the less invasive procedure for preserving palatopharyngeal muscle than barbed reposition pharyngoplasty, and the comparisons of cured rates between BRP and BRP were not statically significant [ 42 ]. In our study, we selected patients with moderate to severe OSA and proved multilevel collapse (retropalatal and retroglossal spaces collapse) for multilevel surgery by DISE.…”

Section: Discussionmentioning

confidence: 99%

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Combined Transoral Robotic Tongue Base Surgery and Palate Surgery in Obstructive Sleep Apnea Syndrome: Modified Uvulopalatopharyngoplasty versus Barbed Reposition Pharyngoplasty

Tsou

Hsu

Shih

et al. 2021

JCM

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Background: Successful surgery outcomes are limited to moderate to severe obstructive sleep apnea (OSA) syndrome. Multilevel collapse at retropalatal and retroglossal areas is often found during the drug-induced sleep endoscopy (DISE). Therefore, multilevel surgery is considered for these patients. The aim of our study was to survey surgical outcomes by modified uvulopalatoplasty (UPPP) plus transoral robotic surgery tongue base reduction (TORSTBR) versus barbed repositioning pharyngoplasty (BRP) plus TORSTBR. Methods: The retrospective cohort study was performed at a tertiary referral center. We collected moderate to severe OSA patients who were not tolerant to positive pressure assistant PAP from September 2016 to September 2019; pre-operative–operative Muller tests all showed retropalatal and retroglossal collapse; pre-operative Friedman Tongue Position (FTP) > III, with the tonsils grade at grade II minimum, with simultaneous velum (V > 1) and tongue base (T > 1), collapsed by drug-induced sleep endoscopy (DISE) under the VOTE grading system. The UPPP plus TORSTBR (n = 31) and BRP plus TORSTBR (n = 31) techniques were offered. We compare the outcomes using an Epworth sleepiness scale (ESS) questionnaire, and measure the patients’ apnea–hypopnea index (AHI), lowest O2 saturation, cumulative time spent below 90% (CT90), and arousal index (AI) by polysomnography six months after surgery; we also measure their length of hospital stay and complications between these two groups. Results: Comparing BRP plus TORSTBR with UPPP plus TORSTBR, the surgical success rate is 67.74% and 38.71%, respectively. The significantly higher surgical success rate in the BRP plus TORSTBR group was noted. The surgical time is shorter in the BRP plus TORSTBR group. The complication rate is not significant in pain, bleeding, dysgeusia, dysphagia, globus sensation, and prolonged suture stay, even though the BRP plus TORSTBR rendered a higher percentage of globus sensation during swallowing and a more prevalent requirement of suture removal one month after surgery. The length of hospital stay is not significantly different between the two groups. Conclusion: In conclusion, BRP plus TORSTBR is a considerable therapy for moderate to severe OSA patients with DISE showing a multi-level collapse in velum and tongue base area. The BRP technique might offer a better anterior–posterior suspension vector for palate level obstruction.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Combined Transoral Robotic Tongue Base Surgery and Palate Surgery in Obstructive Sleep Apnea Syndrome: Modified Uvulopalatopharyngoplasty versus Barbed Reposition Pharyngoplasty

Tsou

Hsu

Shih

et al. 2021

JCM

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“…Once the muscular fibers are fixed laterally, the suture is directed to the hamulus, and then, to the first insertion point. A nonresective technique, barbed suspension pharyngoplasty (BSP), was also presented in 2019 by M. Barbieri et al [ 24 ]. After a tonsillar fossa mucosectomy or a bilateral tonsillectomy, as in BRBT, no further tissue dissection is executed, but a bidirectional barbed suture is performed in order to lateralize LPW and to give more tension to the soft palate.…”

Section: Discussionmentioning

confidence: 99%

Manipulation of Lateral Pharyngeal Wall Muscles in Sleep Surgery: A Review of the Literature

Cammaroto

Stringa

Iannella

et al. 2020

IJERPH

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Background: Obstructive sleep apnea syndrome (OSAS) occurs due to upper airway obstruction resulting from anatomical and functional abnormalities. Upper airway collapsibility, particularly those involving the lateral pharyngeal wall (LPW), is known to be one of the main factors contributing to the pathogenesis of OSAS, leading the authors of the present study to propose different strategies in order to stiffen the pharyngeal walls to try to restore normal airflow. Methods: An exhaustive review of the English literature on lateral pharyngeal wall surgery for the treatment of OSAS was performed using the PubMed electronic database. Results: The research was performed in April 2020 and yielded approximately 2000 articles. However, considering the inclusion criteria, only 17 studies were included in the present study. Conclusions: The analyzed surgical techniques propose different parts of LPW on which to focus and a variable degree of invasivity. Despite the very promising results, no gold standard for the treatment of pharyngeal wall collapsibility has been proposed. However, thanks to progressive technological innovations and increasingly precise data analysis, the role of LPW surgery seems to be crucial in the treatment of OSAS patients.

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“…Pianta y cols 30 y Sorrenti y cols 31 presentaron diferentes modificaciones con sutura barbada de la ESP para manejo de PLO. Finalmente, Barbieri y cols describieron la faringoplastía de suspensión barbada, que modifica la BRP para mejorar su manejo de la LMP 32 . En este estudio, existen limitaciones de la metodología que son difíciles de soslayar y forman parte de la práctica habitual en cirugía y medicina del sueño.…”

Section: Discussionunclassified

Faringoplastía de reposición con suturas barbadas como tratamiento quirúrgico en pacientes con síndrome de apnea-hipopnea obstructiva del sueño

2020

Rev. Otorrinolaringol. Cir. Cabeza Cuello

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

Cited by 32 publications

References 16 publications

Combined Transoral Robotic Tongue Base Surgery and Palate Surgery in Obstructive Sleep Apnea Syndrome: Modified Uvulopalatopharyngoplasty versus Barbed Reposition Pharyngoplasty

Combined Transoral Robotic Tongue Base Surgery and Palate Surgery in Obstructive Sleep Apnea Syndrome: Modified Uvulopalatopharyngoplasty versus Barbed Reposition Pharyngoplasty

Manipulation of Lateral Pharyngeal Wall Muscles in Sleep Surgery: A Review of the Literature

Faringoplastía de reposición con suturas barbadas como tratamiento quirúrgico en pacientes con síndrome de apnea-hipopnea obstructiva del sueño

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