Cautery-assisted palatal stiffening operation☆

Mair, Eric A.; Day, Richard H.

doi:10.1016/s0194-5998(00)70099-4

Cited by 39 publications

(37 citation statements)

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“…In 2000, Mair et al [10] documented a 77 % success rate for snoring reduction in 206 patients (a 1 year follow up) who underwent the cautery-assisted palatal stiffening operation (CAPSO). Pang et al [11] modified the CAPSO technique and had showed encouraging results in a small group of patients with snoring and mild OSA.…”

Section: Discussionmentioning

confidence: 99%

“…Kamami et al had 417 snorers who underwent LAUP and found a reduction of snoring in 95 % of the patients, after 1 year. Most authors report modest improvement after LAUP for patients with mild OSA [9,10,15]. By combining the use of cautery The difference was noted in these two groups, but may be attributed to the drop in BMI in the No DISE group of 6.7, compared to the DISE group where there was a gain of 0.5 (p \ 0.001) with the principles of the laser palatoplasty technique and the creation of a horizontal denuded mucosal strip on the soft palate, with the suturing/closure of this horizontal strip, this technique is able to move the soft palate anteriorly and superiorly, while opening up the anterior-posterior velopharyngeal space.…”

Section: Discussionmentioning

confidence: 99%

“…The palatal stiffening operation was first introduced by Ellis [9] (this involved stripping of a small area of uvular and palatal mucosa) and modified by Mair [10]. Both techniques had promising results, although it produced a stellate and puckered scar on the soft palate that resulted in tenting and pulling of the lateral pharyngeal walls medially, and therefore narrowing of the lateral distance between the tonsillar pillars laterally.…”

Section: Introductionmentioning

confidence: 99%

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Combined Expansion Pharyngoplasty and Anterior Palatoplasty for the Treatment of OSA

Pang¹,

Piccin

Pang³

et al. 2016

Indian J Otolaryngol Head Neck Surg

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To evaluate the success rates of combined Expansion Sphincter Pharyngoplasty and the Anterior Palatoplasty in the treatment of OSA. A two center prospective series of 73 patients with OSA. All patients were [18 years old, retro-palatal obstruction, concentric velo-pharyngeal collapse, BMI \ 33, Friedman clinical stage II, with all grades of AHI. The procedure involved the anterior palatoplasty, tonsillectomy and expansion sphincter pharyngoplasty with or without nasal surgery. There were 68 men and 5 women, the mean age was 46.8 years old (range of 25-67 years), mean BMI was 25.5 (range of 20.3-31.2). All patients had pre-operative and post-operative PSG. The AHI improved in all patients, mean AHI improved from 26.3 ± 17.7 to 12.6 ± 5.8 (p \ 0.001). There were 20 mild OSA, 33 moderate OSA and 20 severe OSA patients. Twenty-three patients had preoperative DISE, and 61 patients had nose/palate surgery, while only 12 had palate surgery alone. The overall success rate (50 % reduction and AHI \ 20) was 86.3 %. The mean snore scores (VAS) improved from 8.8 ± 1.2 to 2.0 ± 1.3 (p \ 0.001). The mean Epworth score improved from 11.5 ± 2.2 to 2.9 ± 2.1 (p \ 0.001). Lowest oxygen saturation also improved in all patients. Subjectively, all the patients felt less tiredness. Pre-operative DISE assessment did not seem to confer any advantage over the patients who had no pre-operative DISE (p = 0.027), and patients who had nose/palate surgery seemed to have better success rates compared to those who only had palate surgery (p = 0.081). This combined technique has been shown to be effective in selected group of OSA patients. Level of evidence IV.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Combined Expansion Pharyngoplasty and Anterior Palatoplasty for the Treatment of OSA

Pang¹,

Piccin

Pang³

et al. 2016

Indian J Otolaryngol Head Neck Surg

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“…This can happen either mechanically with heat energy, radiofrequency, and electrical cautery, or with a chemical inflammatory response (injection snoreplasty). 8,[11][12][13] Possible softening or remodeling of the scar tissue occurs over time, so this may lead to a recurrence of snoring. Mucosal ulcerations, palatal sloughing, fistulas, or infections have been reported rarely after these procedures.…”

Section: Discussionmentioning

confidence: 99%

Do palatal implants really reduce snoring in long‐term follow‐up?

et al. 2009

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“…The other approach aims to affect the tone and/ or size of the soft palate and/or upper throat. The treatment could also be divide in: nonsurgical (weight reduction, reduction of alcohol intake, pharmacological treatment of coincident nasal obstruction [13][14][15][16] , Continuous Positive Airway Pressure (CPAP) appliance 23 , Mandibular Advancement Oral Appliances 24,25 , and surgical (surgery for coincident nasal obstruction 26 , uvulopalatopharyngoplasty 27,28 , palatal stiffening techniques [29][30][31][32][33][34] , palatal shortening techniques) [35][36][37] . Based on these approaches, methods to increase muscle tonus of upper airway, such as singing exercises, miofunctional therapy, instrumental therapy (music), and electrical stimulation have been used as an alternative treatment for snoring.…”

Section: Dr Gilmar Fernandes Do Prado -Rua Claudio Rossi 394 -01547-mentioning

confidence: 99%

Methods to increase muscle tonus of upper airway to treat snoring: systematic review

Valbuza

Oliveira

Conti

et al. 2008

Arq. Neuro-Psiquiatr.

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-Background:Snoring is the noise caused by vibration during the in-breath; and which structure actually vibrates depends on many factors. Objective: The treatment of snoring with methods to increase muscle tonus of upper airway has been controversial, and poorly reported, thus a review of evidence is necessary to evaluate the effectiveness of these methods. Method: A review of randomized or quasi-randomized, double blind trials on snoring treatment that have employed any method to increase muscle tonus of upper airway like phonotherapy or physical therapy among others. Outcomes: decrease or completely stop of snoring, sleep quality, quality of life, and adverse events. Results: Three eligible trials were potentially analyzed, but none of them could provide good scientific evidence favoring the intervention. The objective analyses of one study showed improvement of snoring, although the objective sub-analyses and subjective analyses showed controversial results. The adverse events were not reported. Conclusion: There is no enough evidence to support the recommendation of methods to increase muscle tonus of upper airways in treatment of snoring. Well designed randomized clinical trials are needed to asses the efficacy of such methods, and a standard and worldwide accepted method for snoring assessment would be useful for future researches.Key WOrdS: snoring, sleep disorders, treatment, review. Métodos para aumentar o tônus muscular da via aérea superior no tratamento do ronco: revisão sistemáticaResumo -Contexto: O ronco é o ruído causado pela vibração durante a inspiração, cujas estruturas vibratórias, dependem atualmente de vários fatores. Objetivo: O tratamento do ronco com métodos para aumentar o tônus muscular da via aérea superior tem sido controverso e pouco relatado, portanto uma revisão de evidências é necessária para avaliar a efetividade destes métodos. Método: revisão sistemática de ensaios clínicos randomizados ou quasi-randomizados, duplo-cegos para o tratamento do ronco, com métodos visando o aumento do tônus da via aérea superior, tais como fonoterapia e fisioterapia. desfechos: diminuição ou cura do ronco, qualidade do sono, qualidade de vida e efeitos adversos. Resultados: Três estudos elegíveis foram potencialmente analisados, porém nenhum deles demonstrou evidência científica de qualidade favorecendo a intervenção. As análises subjetivas em um estudo mostrou melhora do ronco, entretanto as sub-análises objetivas demonstraram resultados controversos. Os efeitos adversos não foram relatados. Conclusão: Não existe evidência científica suficiente para sustentar a recomendação de métodos para aumentar o tônus muscular da via aérea superior no tratamento do ronco. ensaios clínicos randomizados bem elaborados são necessários para avaliarmos a eficácia de tais métodos e uma padronização de métodos para intervir no ronco mundialmente aceitos se tornariam úteis em pesquisas futuras. Snoring is caused by vibration during the in-breath, which structure actually vibrates depends on many factors, fe...

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Cautery-assisted palatal stiffening operation☆

Cited by 39 publications

References 0 publications

Combined Expansion Pharyngoplasty and Anterior Palatoplasty for the Treatment of OSA

Combined Expansion Pharyngoplasty and Anterior Palatoplasty for the Treatment of OSA

Do palatal implants really reduce snoring in long‐term follow‐up?

Methods to increase muscle tonus of upper airway to treat snoring: systematic review

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