title: Long-term results of a modified expansion sphincter pharyngoplasty for sleep-disordered breathing.
abstract: Our aim was to evaluate the long-term objective and subjective results of a modified expansion sphincter pharyngoplasty (ESP) technique in patients with sleep-disordered breathing. Single center prospective study of 35 patients underwent an ESP as a primary surgical treatment between June 2012 and September 2015 at the hospital AZ Sint-Jan Bruges-Ostend. Patients were divided into non-OSAS and OSAS (AHI >5). Primary outcome parameters were the Epworth Sleeping Scale (ESS, reduction and score less then 10) and the Visual Analogue Score of snoring (VAS, assessed by partner) evaluated at 3 months and 1 year. In addition, the OSAS group underwent a polysomnography after 6 months to calculate the Apneu-Hypopneu Index (AHI) change. Secondary outcome parameters were possible complications and morbidity rate. The overall Epworth Sleepiness Scale showed a steady total reduction of, respectively, 42 and 48% at the two timepoints. All patients had a post-operative score of less than ten points. The Visual Analogue Score improved in 92% of the patients; of these, the snoring was reduced in 86% and disappeared in 6%. In the OSAS group, we noticed a reduction in AHI of more than 50 in 53% of the patients. A considerable reduction was found in the severe OSAS group, where we found a mean pre-operative average AHI of 41.3/h that was reduced 6 months after the operation to 17.4/h. There were no severe complications or increased morbidity rate observed. This first long-term study shows that the modified ESP seems to be a safe and promising technique in palatal surgery for patients with sleep-disordered breathing. Surgical effectiveness is sustained after 1 year, both in OSAS as in snoring pathology. The technique seems as approachable for the basic ENT surgeon as the uvulopalatopharynoplasty.
authors.affiliation: AZ Sint-Jan BrugesRuddershove 10, 8000, Brugge, Belgium.
authors.forename: Anne-Sophie
authors.identifier: http://orcid.org/0000-0003-0685-3170
authors.initials: AS
authors.lastname: Despeghel
authors.affiliation: AZ Sint-Jan BrugesRuddershove 10, 8000, Brugge, Belgium.
authors.forename: Lisabeth
authors.initials: L
authors.lastname: Mus
authors.affiliation: AZ Sint-Jan BrugesRuddershove 10, 8000, Brugge, Belgium.
authors.forename: Catherine
authors.initials: C
authors.lastname: Dick
authors.affiliation: AZ Sint-Jan BrugesRuddershove 10, 8000, Brugge, Belgium.
authors.forename: Stephan
authors.initials: S
authors.lastname: Vlaminck
authors.affiliation: AZ Sint-Jan BrugesRuddershove 10, 8000, Brugge, Belgium.
authors.forename: Rudolf
authors.initials: R
authors.lastname: Kuhweide
authors.affiliation: AZ Sint-Jan BrugesRuddershove 10, 8000, Brugge, Belgium.
authors.forename: Bob
authors.initials: B
authors.lastname: Lerut
authors.affiliation: AZ Sint-Jan BrugesRuddershove 10, 8000, Brugge, Belgium.
authors.forename: Kato
authors.initials: K
authors.lastname: Speleman
authors.affiliation: AZ Sint-Jan BrugesRuddershove 10, 8000, Brugge, Belgium.
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Vinck
authors.affiliation: AZ Sint-Jan BrugesRuddershove 10, 8000, Brugge, Belgium. tom.vauterin@azsintjan.be.
authors.forename: Tom
authors.initials: T
authors.lastname: Vauterin
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010614:Pharynx / Q000601:surgery*; D017286:Polysomnography; D011446:Prospective Studies; D019651:Plastic Surgery Procedures; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D012913:Snoring / Q000209:etiology / Q000517:prevention & control / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome
keywords: Expansion pharyngoplasty; Obstructive sleep apnea; Sleep-disordered breathing; Surgical treatment; Uvulopalatopharyngoplasty