Clinical outcomes of expansion sphincter pharyngoplasty-a 17-year systematic review

Abstract

Objectives: To systematically review long-term (> 5 years) outcomes of ESP surgery for OSA treatment over 17 years.

Methods: Systemic review of MEDLINE, Google Scholar, Cochrane Library and Evidence Based Medicine Reviews to identify publications relevant to OSA and Expansion Pharyngoplasty and its variants. All relevant studies published between January 2007 and June 2023 were included.

Results: Twelve studies were included in this systematic review with a combined total of 1373 patients who had the ESP procedure were included. The clinical outcomes included encouraging long-term success rate, reductions in Epworth sleepiness scale, good mean disease alleviation, anatomical structural area and volume improvements, blood pressure reductions, biochemical improvements in acute phase reactants after ESP surgery, reductions in intra-ocular pressures, and post-operative reduction of sympathetic overdrive.

Conclusions: Seventeen years on, the expansion sphincter pharyngoplasty has demonstrated not only increase in anatomical area and volume but significant desired improvements in polysomnographic, clinical and biochemical parameters post-surgery.

Keywords: Clinical outcomes; Expansion sphincter pharyngoplasty; Obstructive sleep apnea; Systemic review.