title: Transpalatal advancement pharyngoplasty for obstructive sleep apnea syndrome: results and analysis of failures.
abstract: OBJECTIVE
  To assess the polysomnographic outcomes of patients with obstructive sleep apnea undergoing transpalatal advancement pharyngoplasty for retropalatal collapse and to compare responders with nonresponders to surgery.
  
  
  METHODS
  Retrospective medical record review.
  
  
  METHODS
  Tertiary referral teaching hospital and private practice.
  
  
  METHODS
  Sixty patients undergoing transpalatal advancement pharyngoplasty alone at a single sitting with preoperative and postoperative sleep studies were reviewed.
  
  
  METHODS
  Transpalatal advancement pharyngoplasty.
  
  
  METHODS
  Preoperative and postoperative polysomnographic data were analyzed and comparisons were assessed between responders and nonresponders.
  
  
  RESULTS
  Following surgery, the mean (SD) respiratory disturbance index (RDI) decreased from 37.2 (20.4) to 15.4 (12.3), with an overall change of 21.8 (21.8) (95% confidence interval [CI], 16.2-27.4). Similarly, the mean (SD) arterial oxygen saturation nadir after transpalatal advancement pharyngoplasty surgery improved from 83.9% (5.4%) to 87.4% (4.3%), with an overall change of 3.5% (5.9%) (95% CI, 2.0%-5.0%). Between the traditional Gothic arch incision (n = 31) and the propeller incision (n = 29) an observed 31% (95% CI, 7%-51%) difference in success rate in favor of the latter was noted.
  
  
  CONCLUSIONS
  Transpalatal advancement pharyngoplasty appears to be an effective and safe treatment option in selected patients. No preoperative variable was associated with surgical success in this study. The association of the propeller incision and surgical success requires further analysis.
authors.affiliation: Department of Otolaryngology, St Johns Hospital, Edinburgh, Scotland. shiner1@gmail.com
authors.forename: Neville Patrick
authors.initials: NP
authors.lastname: Shine
authors.forename: Richard Hamilton
authors.initials: RH
authors.lastname: Lewis
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019647:Oral Surgical Procedures; D010159:Palate / Q000601:surgery; D010614:Pharynx / Q000601:surgery; D017286:Polysomnography; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D017211:Treatment Failure; D016896:Treatment Outcome