Barbed reposition pharyngoplasty (BRP) in obstructive sleep apnea treatment: State of the art

Am J Otolaryngol. 2022 Jan-Feb;43(1):103197. doi: 10.1016/j.amjoto.2021.103197. Epub 2021 Sep 1.

Abstract

Purpose: In this paper, we perform a systematic review that discusses the state of the art and evolution on the barbed reposition pharyngoplasty (BRP) in the velo-pharyngeal surgery. Clinical evidence and published outcomes of this surgical technique are reported and discussed.

Materials and methods: We performed a systematic review of the current literature through the analysis of the last 10 years of literature on barbed palate surgery. Study design, number of patients enrolled, inclusion criteria, pre- and posttreatment outcomes (AHI, ODI), surgical success rate, follow-up time and complication has been collected and reported.

Results: 15 studies for a total of 1531 patients, out of which 1061 underwent barbed reposition pharyngoplasty. Five trials were uncontrolled prospective studies (215 patients, 14% of total), nine were retrospective studies (1266 patients, 82,6% of total), and one randomized prospective clinical trial (RCT) (50 patients, 3,32% of total). All analyzed studies reported good outcomes after BRP surgery. Average preoperative values of AHI and ODI reduced in all studies considered with a significative statistical difference between preoperative and postoperative values (p < 0.05 in all cases). The postoperative surgical success rate ranged between 65.4 and 93% of cases. There were no significant intra-operative or post-operative complications in all studies considered in this systematic review.

Conclusions: Barbed reposition pharyngoplasty has proven to be an easy to learn, quick, safe and effective new palatopharyngeal procedure, that can be used in a single level surgery or as a part of multilevel procedures.

Keywords: Barbed pharyngoplasty; Barbed suture; Obstructive sleep apnea; Respiratory disease; Systematic review.

Publication types

  • Systematic Review

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Male
  • Middle Aged
  • Otorhinolaryngologic Surgical Procedures / methods*
  • Otorhinolaryngologic Surgical Procedures / trends*
  • Palate, Soft / surgery*
  • Pharynx / surgery*
  • Safety
  • Sleep Apnea, Obstructive / surgery*
  • Treatment Outcome