Lateral pharyngoplasty: A new treatment for obstructive sleep apnea hypopnea syndrome

Cahali, Michel Burihan

doi:10.1097/00005537-200311000-00020

Cited by 219 publications

(149 citation statements)

References 30 publications

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“…The expansion sphincter pharyngoplasty was inspired by and modified from the Orticochea [7] procedure and the lateral pharyngoplasty, described by Cahali [5]. The principle of this technique is to de-bulk and isolate the palatopharyngeus muscle (the main part of the lateral pharyngeal wall bulk) and rotate this muscle supero-anterolaterally, in order to create the lateral wall anterolatero-superior tension and reduce the bulk of the lateral pharyngeal walls.…”

Section: Discussionmentioning

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%

“…The lateral pharyngoplasty, first described by Cahali [5], was aimed at addressing the lateral pharyngeal wall collapse in patients with OSA. The procedure showed promising results; however, many patients had dysphagia post-operatively.…”

Section: Introductionmentioning

confidence: 99%

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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“…Ademais, nos primeiros dias de pós-operatório existe um edema da região faríngea, que pode estreitar a VAS, e piorar o quadro de SAOS neste período. Os autores afirmam que os resultados da FL são máximos após o período de três a seis meses do procedimento, inclusive apresentando melhores resultados clínicos e polissonográficos que a uvulopalatofaringoplastia (UPFP) (Cahali, 2003;Cahali, Formigoni, Gebrim, & Miziara, 2004). Nesse sentido uma nova avaliação, após intervalo de tempo maior, é recomendada a fim de verificar se os dados obtidos se mantêm.…”

Section: Discussionunclassified

Síndrome da Apneia Obstrutiva do Sono: Avaliação da Ansiedade em Pacientes Recém-diagnosticados

Santos¹,

Nakano²

2016

Inter. Psicol.

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RESUMOCom o objetivo de analisar e identificar os níveis de ansiedade em uma amostra de portadores da síndrome da apneia obstrutiva do sono, antes e após um mês de tratamento clínico ou cirúrgico, a Escala de Ansiedade Beck foi aplicada em uma amostra de 18 pacientes com esse diagnóstico. Resultados mostraram que 55,5% dos participantes apresentavam ansiedade na primeira avaliação (antes do início do tratamento), entre os níveis leve, moderado e grave. Na segunda avaliação (um mês após início do tratamento) os pacientes apresentaram diminuição significativa na média de sintomas de ansiedade pós-início de tratamento (z=-3,51, p0,000). Estudos envolvendo outras variáveis, tais como adaptação ao tratamento, avaliação da qualidade do sono e efeitos de um programa de intervenção são recomendados.Palavras-chave: avaliação psicológica; ansiedade; transtornos do sono. ABSTRACT Obstructive Sleep Apnea Syndrome: Anxiety Assessment in Patients Newly DiagnosedAiming to analyze and identify the levels of anxiety in a sample of patients with obstructive sleep apnea syndrome before and after a month of medical or surgical treatment, the Beck Anxiety Scale was administered to a sample of 18 patients with this diagnosis. Results showed that 55.5% of the participants reported anxiety at the first assessment (before starting treatment), between the low, moderate and severe levels. In the second evaluation (one month after initiation of treatment) patients showed a significant decrease in mean symptoms of post-treatment initiation (z = -3.51, p <0.000) anxiety. Studies involving other variables, such as adaptation to treatment, assessment of sleep quality and effects of a program of intervention are recommended.

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“…These patients have an exceedingly collapsible lateral pharyngeal wall during respiration, which is associated with a muscle thickening at this region that narrows the pharynx in the lateral dimension. 1 Moreover, surgeries that act on the musculature of the lateral wall, such as lateral pharyngoplasty 2 and maxillomandibular advancement, 3 are more effective in reducing OSA severity than surgeries that excise and reconstruct tissues of the pharyngeal surface, such as uvulopalatopharyngoplasty. 4 The superior pharyngeal constrictor is a skeletal muscle that forms the deep lateral and posterior layer of the pharyngeal airway.…”

Section: Introductionmentioning

confidence: 99%

The Extracellular Matrix of the Lateral Pharyngeal Wall in Obstructive Sleep Apnea

Dantas

Mauad

Silva

et al. 2012

Sleep

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Lateral pharyngoplasty: A new treatment for obstructive sleep apnea hypopnea syndrome

Abstract: Lateral pharyngoplasty is a safe and straightforward approach to lateral pharyngeal muscles and has produced appreciable benefits for OSAHS patients.

Cited by 219 publications

References 30 publications

Combined Expansion Pharyngoplasty and Anterior Palatoplasty for the Treatment of OSA

Combined Expansion Pharyngoplasty and Anterior Palatoplasty for the Treatment of OSA

Síndrome da Apneia Obstrutiva do Sono: Avaliação da Ansiedade em Pacientes Recém-diagnosticados

The Extracellular Matrix of the Lateral Pharyngeal Wall in Obstructive Sleep Apnea

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