title: Modified barbed soft palatal posterior pillar webbing flap palatopharyngoplasty.
abstract: BACKGROUND
  The soft palate and the lateral pharyngeal walls contribute to the collapse of the upper airway in patients with snoring and obstructive sleep apnea. In this study, the original soft palatal webbing flap palatopharyngoplasty for both soft palatal and oropharyngeal lateral wall collapse has been modified to include all tonsil grades and to apply the barbed suture technique.
  
  
  METHODS
  Twenty-one adults with significant soft palatal webbing, lateral pharyngeal wall collapse, and tonsil hypertrophy of any grade were selected for the study with a minimum follow-up period of 6 months.
  
  
  RESULTS
  Snoring was improved with snoring scale reduced from 9.4 ± 1.6 to 1.7 ± 3.2 (p < 0.005). The preoperative to postoperative apnea-hypopnea index (AHI) statistically improved from 45.7 ± 2.6 to 12.3 ± 3.9 (p < 0.005) and lowest O2 saturation from 73.8 ± 3.6 to 89.4 ± 1.9 % (p < 0.005). Postoperative endoscopic findings showed significant improvement in soft palatal and lateral pharyngeal wall collapse. There were no significant intraoperative or postoperative complications.
  
  
  CONCLUSIONS
  Modified barbed soft palatal webbing flap palatopharyngoplasty provided objective improvement of obstructive sleep apnea (OSA) in adults with soft palatal, lateral pharyngeal wall collapse and tonsillar hypertrophy, with no significant complications and has the potential to serve as an effective alternative for these cases.
authors.affiliation: The Department of Otolaryngology, Faculty of Medicine, Cairo University, Giza, Egypt. ahmedeldeen662000@yahoo.com.|The Department of Otolaryngology, Al Salam International Hospital, P.O. BOX: 11023, Dasma, 3515, Kuwait City, Kuwait. ahmedeldeen662000@yahoo.com.
authors.forename: Ahmed Mohamed Mohyee Eldin
authors.initials: AM
authors.lastname: Elbassiouny
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D006984:Hypertrophy; D008297:Male; D008875:Middle Aged; D009960:Oropharynx / Q000601:surgery*; D010160:Palate, Soft / Q000601:surgery*; D014066:Palatine Tonsil / Q000473:pathology; D010614:Pharynx / Q000601:surgery*; D013524:Surgical Flaps; D013536:Suture Techniques
keywords: Barbed suture technique; Lateral pharyngeal wall collapse; Obstructive sleep apnea; Soft palatal collapse; Tonsil hypertrophy