Expansion sphincter pharyngoplasty: a new technique for the treatment of obstructive sleep apnea.
OBJECTIVE
In this study, we assessed the efficacy of a new method (expansion sphincter pharyngoplasty [ESP]) to treat obstructive sleep apnea.


METHODS
We conducted a prospective, randomized controlled trial.


METHODS
Forty-five adults with small tonsils, body mass index less than 30 kg/m2, of Friedman stage II or III, of type I Fujita, and with lateral pharyngeal wall collapse were selected for the study.


RESULTS
The mean body mass index was 28.7 kg/m2. The apnea-hypopnea index improved from 44.2 +/- 10.2 to 12.0 +/- 6.6 (P < 0.005) following ESP and from 38.1 +/- 6.46 to 19.6 +/- 7.9 in the uvulopalatopharyngoplasty group (P < 0.005). Lowest oxygen saturation improved from 78.4 +/- 8.52% to 85.2 +/- 5.1% in the ESP group (P = 0.003) and from 75.1 +/- 5.9% to 86.6 +/- 2.2% in the uvulopalatopharyngoplasty group (P < 0.005). Selecting a threshold of a 50% reduction in apnea-hypopnea index and apnea-hypopnea index less than 20, success was 82.6% in ESP compared with 68.1% in uvulopalatopharyngoplasty (P < 0.05).


CONCLUSIONS
The ESP may offer benefits in a selected group of OSA patients.
Pang
Kenny P
KP
Deaprtment of Otolaryngology, Pacific Sleep Centre, 20-01 Paragon, Paragon Medical Centre, Singapore, Republic of Singapore. kennypang@hotmail.com
Woodson
B Tucker
BT
D000328:Adult; D015992:Body Mass Index; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010156:Palatal Muscles / Q000601:surgery; D010609:Pharyngeal Muscles / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000145:classification / Q000601:surgery*; D013536:Suture Techniques; D014068:Tonsillectomy; D016896:Treatment Outcome; D014609:Uvula / Q000601:surgery
D010100:Oxygen