Supine or non-supine apnea; which can be treated better with expansion sphincter pharyngoplasty?

SÜSLÜ A. E., KATAR O., Kulekci C.

AURIS NASUS LARYNX, vol.49, no.3, pp.431-436, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 49 Issue: 3
  • Publication Date: 2022
  • Doi Number: 10.1016/j.anl.2021.10.009
  • Journal Name: AURIS NASUS LARYNX
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CINAHL, EMBASE, MEDLINE
  • Page Numbers: pp.431-436
  • Keywords: Sleep apnea, Obstructive, Treatment outcome, Otorhinolaryngologic surgical, procedures, Palate, Pharynx, OBSTRUCTIVE SLEEP-APNEA, SURGICAL SUCCESS, POSITION, SURGERY, DEPENDENCY, OSA
  • Hacettepe University Affiliated: Yes


Objectives: Expansion sphincter pharyngoplasty is a well-known palatal correction surgery applied for obstructive sleep apnea patients. Even though high success rates are reported, in some patients, the desired outcome cannot be achieved. Therefore, patient selection is crucial to avoid undesirable outcomes. In this study we present our results with expansion sphincter pharyngoplasty, and we aim to show the difference between supine and non-supine apnea in terms of their response to the surgery, in order to utilize position dependency for selection of surgical candidates.Methods: Pre- and post-operative polysomnography results of patients who underwent expansion sphincter pharyngoplasty were analyzed retrospectively. Total AHI, supine AHI, non-supine AHI, supine/non-supine AHI ratio and surgical success values are compared.Results: 85 patients were included to the study. Mean AHI significantly decreased from 48.7 +/- 27.99 to 26.37 +/- 21.16 with the surgery. Surgical success rate was found to be 51.8%. Both supine and non-supine apnea decreased significantly with the surgery, but the decrease was significantly higher in non-supine apnea (20.6% to 39.1% respectively, p = 0.016). There was significant negative correlation between pre-operative supine to non-supine AHI ratio and the change in AHI, showing that supine dominant patients had less improvement with the surgery (r = 0.274, p = 0.01).Conclusion: Expansion sphincter pharyngoplasty is an effective surgery which achieves significant improvement in AHI. Non-supine respiratory events respond better to the surgery than supine events. (c) 2021 Japanese Society of Otorhinolaryngology-Head and Neck Surgery, Inc. Published by Elsevier B.V. All rights reserved.