Efficiency of Expansion Sphincter Pharyngoplasty in the Treatment of Obstructive Sleep Apnea Syndrome

Obstructive sleep apnea syndrome (OSAS) is characterized by recurrent episodes of upper respiratory-tract obstruction during sleep and decrease in arterial oxygen saturation. Expansion sphincter pharyngoplasty (ESP) is a simple, safe, and effective method for the surgical treatment of OSAS. The aim of our study was to evaluate the efficacy of ESP with polysomnography (PSG) in OSAS patients.

This study was conducted on patients referred to our center for the treatment of snoring, apnea, witnessed apnea, and daytime sleepiness during 2010-2018. Overall, 67 patients (16 females, 51 males) who had PSG test at postoperative three months and were considered suitable with history, physical examination, and surgery after PSG were included in the study. Patients were classified into three groups according to OSAS severity: mild, moderate, and severe. Patient age, sex, body mass index (BMI), pre- and postoperative period apnea-hypopnea index (AHI), Epworth sleepiness scores, and PSG data were recorded.

The mean BMI of all groups was 27.44±2.73. The postoperative AHI decreased from 18.26±2.23 to 8.01±0.97 (p<0.001). Surgical success rate was 67.2%; it was higher in females (p=0.047). The highest success rate was found in the mild OSAS group; however, this difference was not statistically significant when compared to the other groups (p=0.217). There were statistically significant improvement at postoperative Epworth sleepiness scores and minimum O₂ saturations (p<0.001 and p=0.018, respectively).

ESP is an effective and successful surgery in selected patients with lateral pharyngeal and retropalatal narrowing.