Palatopharyngeal muscle suspension suture technique for patients with obstructive sleep apnea

Am J Otolaryngol. 2022 Nov-Dec;43(6):103560. doi: 10.1016/j.amjoto.2022.103560. Epub 2022 Aug 6.

Abstract

Purpose: Palatal surgery remains a major option for patients with obstructive sleep apnea (OSA). We sought to evaluate the therapeutic outcomes of the palatopharyngeal muscle suspension suture technique (PSST) as a novel palatal surgery for patients with OSA.

Materials and methods: Of the 816 patients who underwent polysomnography (PSG) from February 1, 2017, to June 30, 2020, 30 patients with OSA who underwent PSST were retrospectively reviewed. The medical records of the patients were also recorded. Among the 30 patients with OSA, nine who underwent preoperative and postoperative PSG were analyzed.

Results: Of the 30 patients with OSA, 28 (93.3 %) were male. The mean (SD, standard deviation) age was 43.3 (12.7) years, and the mean (SD) body mass index was 27.3 (3.2). As objective parameters, the mean (SD) apnea-hypopnea index was significantly decreased from 45.9 (21.20) to 29.03 (21.62) (p < 0.05) and the mean (SD) lowest oxygen saturation improved significantly from 77.6 % (7.14 %) to 84.6 (5.17 %) (p < 0.05). As a subjective parameter, the mean (SD) Epworth Sleepiness Scale score decreased significantly from 10 (4.95) to 6.9 (4.57) (p < 0.05), and the mean (SD) visual analog scale score for snoring decreased significantly from 6.3 (1.8) to 3.1 (1.9) (p < 0.001). No complications, such as upper airway obstruction, intractable postoperative bleeding, or velopharyngeal insufficiency, were observed in any of the patients postoperatively.

Conclusions: A novel palatal surgery, PSST, has numerous advantages as a useful surgical option for patients with OSA. It is minimally invasive, easy, time-saving, and relatively reversible.

Keywords: Apnea-hypopnea index; Daytime sleepiness; Obstructive sleep apnea; Palatopharyngeal muscle suspension suture technique; Snoring.

MeSH terms

  • Adult
  • Female
  • Humans
  • Male
  • Pharyngeal Muscles / surgery
  • Retrospective Studies
  • Sleep Apnea, Obstructive* / surgery
  • Suture Techniques
  • Treatment Outcome