Modified barbed reposition pharyngoplasty with symmetrical flap for acquired nasopharyngeal stenosis

Acquired nasopharyngeal stenosis (NPS) is a rare but serious complication following tonsillectomy or laser-assisted uvulopalatoplasty, leading to choking sensation and impaired nasal breathing. This study aimed to describe a modified pharyngoplasty technique and report its short-term outcomes.

A retrospective analysis was conducted on five patients with acquired NPS who underwent the procedure between 2017 and 2025. All cases were refractory to conservative treatment. The surgical technique involved symmetrical mucosal flaps combined with absorbable barbed sutures to achieve stable expansion of the pharyngeal airway.

All patients showed rapid improvement in choking sensation and nasal breathing postoperatively. Normal speech and oral intake were possible from the day after surgery. During follow-up (5 months-2 years), no restenosis or major complications were observed, and endoscopic findings confirmed sustained airway patency.

This technique can be performed safely in a single session without muscle resection or stenting and demonstrated favorable short-term outcomes. It may represent a practical surgical option for selected patients with acquired NPS. Further studies are required to confirm long-term efficacy.