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83rd Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

16.05. - 20.05.2012, Mainz

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The expansion sphincter pharyngoplasty in the multi level surgery concept for the operative treatment of the obstructive sleep apnea (OSAS)

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  • corresponding author Stefan Wenzel - Asklepios Klinik Harburg, Abt. HNO und KHC, Hamburg, Germany
  • author Kerstin Rohde - Asklepios Klinik Harburg, Abt. HNO und KHC, Hamburg, Germany
  • author Thomas Verse - Asklepios Klinik Harburg, Abt. HNO und KHC, Hamburg, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 83rd Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Mainz, 16.-20.05.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. Doc12hno68

doi: 10.3205/12hno68, urn:nbn:de:0183-12hno686

Published: July 23, 2012

© 2012 Wenzel et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

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Introduction: The tonsillectomy (TE) with uvulo-palato-pharyngoplasty (UPPP) is the standard procedure for treating soft palate and tonsils related obstructions of the upper airways. If the patient has already underwent tonsillectomy earlier this option is missing. In our opinion in these cases the expansion sphincter pharyngoplasty by Pang and Woodson is an alternative. We examined the effectivity and the agreeability of this treatment in tonsillectomied patients with moderate to severe OSAS and CPAP-incompliance.

Patients and methods: From march 2010 to november 2011 we performed 6 expansion sphincter pharyngoplasties by Pang and Woodson as a part oft he multy level surgery concept. Prior to this the site of obstruction was detected by performing a sedated endoscopy. The patients were all male with an average age of 52.5 years, they had an BMI of 31.5 kg/m2, the value on the ESS was 10.8 and the AHI was 46.9/h. Postoperatively the subjective success was mesured on a visual analgue scale (VAS) from 0–10.

Results: Postoperatively the ESS score was 8.8, the AHI was 30.4/h. On the VAS the value was 7.9. Specific complications such as bleedings or a velopharyngeal insufficiency was not seen. The need for painkillers was not higher then after TE with UPPP.

Conclusion: The expansion sphincter pharyngoplasty by Pang and Woodson in the multi level surgery concept in tonsillectomied patients with obstructions of the soft palate seems to be a reasonable option with a passable complication rate. A sedated endoscopy is recommended.