Abstract
This study seeks to determine the success rates of the expansion sphincter pharyngoplasty and its variants on the treatment of obstructive sleep apnea (OSA). Systematic review and meta-analysis. Two independent searches of MEDLINE, Google Scholar, Cochrane Library and Evidence Based Medicine Reviews to identify publications relevant to OSA and expansion pharyngoplasty. All relevant studies published before 31 March 2015 were included. Five studies were included in the systematic review and meta-analysis. The numbers of patients in each paper ranged from 10 to 85 (total = 155), and mean age ranged from 8 to 56 years. Substantial and consistent improvement in PSG outcomes were observed post-expansion pharyngoplasty patients, with or without multilevel surgery groups. The results showed that the expansion pharyngoplasty technique has significantly lower AHI than control group [Standardised mean difference −7.32, 95 %CI (−11.11, −3.52), p = 0.0002]; however, substantial heterogeneity between these studies were observed. The mean pre-operative AHI (in the five papers) improved from 40.0 ± 12.6 to 8.3 ± 5.2 post-operatively. The overall pro-rated pooled success rate for all the patients was 86.3 %. The expansion pharyngoplasty is effective in the management of patients with OSA.
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References
Borowiecki BD, Sassin JF (1983) Surgical treatment of sleep apnoea. Arch Otolaryngol 109:506–512
Terris DJ, Hanasono MM, Liu YC (2000) Reliability of the Muller maneuver and its association with sleep-disordered breathing. Laryngoscope 110:1819–1823
Remmers JE, De Groot WJ, Sauerland EK et al (1978) Pathogenesis of upper airway occlusion during sleep. J Appl Physiol 44:931–938
Schwab RJ, Gefter WB, Hoffman EA et al (1993) Dynamic upper airway imaging during awake respiration in normal subjects and patients with sleep disordered breathing. Am Rev Respir Dis 148:1385–1400
Cahali MB (2003) Lateral Pharyngoplasty: a new treatment for OSAHS. Laryngoscope 113:1961–1968
Pang KP, Woodson BT (2007) Expansion sphincter pharyngoplasty: a new technique for the treatment of obstructive sleep apnea. Otolaryngol Head Neck Surg 137(1):110–114
Orticochea M (1968) Construction of a dynamic muscle sphincter in cleft palates. Plast Reconstr Surg 41:323–327
Christel SR, Georges B, Christel D et al (2004) Sphincter Pharyngoplasty as a treatment of velopharyngeal incompetence in young people. Chest 125:864–871
Vicini C, Montevecchi F, Pang KP, Bahgat A, Dallan I, Frassineti S, Campanini A (2014) Combined transoral robotic tongue base surgery and palate surgery in obstructive sleep apnea-hypopnea syndrome: expansion sphincter pharyngoplasty versus uvulopalatopharyngoplasty. Head Neck 36(1):77–83
Sorrenti G, Piccin O (2013) Functional expansion pharyngoplasty in the treatment of obstructive sleep apnea. Laryngoscope. 123(11):2905–2908
Ulualp SO (2014) Modified expansion sphincter pharyngoplasty for treatment of children with obstructive sleep apnea. JAMA Otolaryngol Head Neck Surg 140(9):817–822
Carrasco-Llatas M, Marcano-Acuña M, Zerpa-Zerpa V, Dalmau-Galofre J (2015) Surgical results of different palate techniques to treat oropharyngeal collapse. Eur Arch Otorhinolaryngol 272(9):2535–2540. doi:10.1007/s00405-015-3565-1
Sher AE, Schechtman KB, Piccirillo JF (1996) The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome. Sleep 19(2):156–177
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Pang, K.P., Pang, E.B., Win, M.T.M. et al. Expansion sphincter pharyngoplasty for the treatment of OSA: a systemic review and meta-analysis. Eur Arch Otorhinolaryngol 273, 2329–2333 (2016). https://doi.org/10.1007/s00405-015-3831-2
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DOI: https://doi.org/10.1007/s00405-015-3831-2