Barbed Expansion Sphincter Pharyngoplasty for the Treatment of Oropharyngeal Collapse in OSAS: a Retrospective Study on 17 patients

Abstract

Expansion Sphincter Pharyngoplasty (ESP) was introduced in 2007 and represents a promising surgical technique to treat patients with oropharyngeal walls collapse with reduced morbidity and high success rates.

Between December 2012 and January 2015 17 patients underwent ESP at the department of Otorhinolaryngology of the University of Brescia (Italy), using barbed knotless sutures to improve the biomechanical effect of sutures on tissue collapse (BESP).

Patients with moderate to severe OSAS and BMI < 30 kg/m², who did not tolerate or refused ventilation therapy, were selected for BESP based on the presence of oropharyngeal collapse, as determined by upper airway examination and drug-induced sleep endoscopy.

Overall success of BESP was 94,1%. Postoperative oxygen desaturation index (ODI) showed significant improvement (P<0.01). Likewise, Epworth Sleepiness Scale score was significantly reduced (P<0.05). No patient complained of uncontrolled pain after the procedure and/or reported unsatisfactory analgesia at follow-up visits.

Albeit limited by the sample size and duration of follow-up, our experience confirms the validity of BESP in this selected patient population.

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