Palatal surgery in a transoral robotic setting (TORS): preliminary results of a retrospective comparison between uvulopalatopharyngoplasty (UPPP), expansion sphincter pharyngoplasty (ESP) and barbed repositioning pharyngoplasty (BRP)

Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale
Giovanni CammarotoClaudio Vicini

Abstract

It has become increasingly clear in the past decade that surgical management of obstructive sleep apnoea hypopnoea syndrome (OSAHS) is most successfully managed with multilevel surgery. We evaluated the outcomes of multilevel interventions comparing three different palatal techniques added to TORS: uvulopalatopharyngoplasty (UPPP), a modified expansion sphincter pharyngoplasty (ESP), inspired by the Pang expansion sphincter pharyngoplasty technique and the latest barbed repositioning pharyngoplasty (BRP). Thirty patients were retrospectively evaluated. Ten patients underwent UPPP by Fairbanks, 10 BRP and 10 a modified ESP already described. All patients underwent TORS, tonsillectomy and septo-turbinoplasty. For all cases, the following data were retrieved and revaluated: preoperative and postoperative apnoea-hypopnoea index (AHI), preoperative and postoperative Epworth Sleepiness Scale (ESS), pain visual analogue scale (VAS; 0-10) for the first 5 days postoperatively, palatal operative time for each surgical technique, discharge date and complication types and rate. Both BRP and ESP resulted in better postoperative AHI values and higher surgical success rates in comparison with UPPP. On the other hand, BRP was not more effectiv...Continue Reading

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