title: Barbed Roman blinds technique for the treatment of obstructive sleep apnea: how we do it?
abstract: Retro-palatal obstruction is often involved in the pathogenesis of obstructive sleep apnea syndrome (OSAS), which is currently treated by means of various surgical procedures. The aim of this paper is to describe our preliminary results using a new, minimally invasive and non-resective procedure called the "barbed Roman blinds technique" (BRBT), which was used to treat severe OSAS due to retro-palatal obstruction. The apnea-hypopnea index (AHI), time with <90 % O2 saturation, and Epworth Sleepiness Scale (ESS) of 32 consecutive adult outpatients (mean age 47.3 ± 8.6 years) were compared before and after surgery. The tolerability of the procedure was assessed using a 0-10 visual analog scale (VAS). All of the treated patients experienced a clinical and subjective improvement as documented by the significant differences (P < 0.001) in their pre- and post-BRBT AHI, time with <90 % O2 saturation, and ESS scores. There were no minor or major adverse events, and the good tolerability of the procedure was documented by the short mean hospital stay (1.2 ± 0.5 days) and the mean VAS value of 4.3 ± 0.7. The mean follow-up period was 12.2 ± 2.0 months. The preliminary results indicate that the BRBT is safe and effective, but long-term follow-up and comparative studies of larger case series are needed to confirm these encouraging findings.
authors.affiliation: Department of Otolaryngology, Department of Clinical Sciences and Community Health, Fondazione I.R.C.C.S. Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Via F. Sforza 35, 20122, Milan, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Mantovani
authors.affiliation: Department of Otolaryngology, Department of Clinical Sciences and Community Health, Fondazione I.R.C.C.S. Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Via F. Sforza 35, 20122, Milan, Italy. rinaldivittorio@yahoo.it.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Rinaldi
authors.affiliation: Department of Otolaryngology, Department of Clinical Sciences and Community Health, Fondazione I.R.C.C.S. Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Via F. Sforza 35, 20122, Milan, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Torretta
authors.affiliation: Department of Otolaryngology, Department of Clinical Sciences and Community Health, Fondazione I.R.C.C.S. Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Via F. Sforza 35, 20122, Milan, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Carioli
authors.affiliation: Department of Otolaryngology, S. Pio X Hospital, Milan, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Salamanca
authors.affiliation: Department of Otolaryngology, Department of Clinical Sciences and Community Health, Fondazione I.R.C.C.S. Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Via F. Sforza 35, 20122, Milan, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Pignataro
mesh_terms: D000328:Adult; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D010160:Palate, Soft / Q000601:surgery*; D010865:Pilot Projects; D017286:Polysomnography; D012890:Sleep / Q000502:physiology*; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology / Q000601:surgery*; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures; D013997:Time Factors; D016896:Treatment Outcome; D014609:Uvula / Q000601:surgery*
keywords: Barbed sutures; Lateral pharyngeal walls; Obstructive sleep apnea syndrome; Snoring