Transpalatal Advancement Pharyngoplasty
August 29th, 2009
Sleep Apnea Surgery – Transpalatal Advancement Pharyngoplasty
Transpalatal Advancement Pharyngoplasty Study
Dr’s Neville Patrick Shine, F.R.C.S. (O.R.L.-H.N.S.), of St. Johns Hospital, Edinburgh, Scotland, and Richard Hamilton Lewis, F.R.A.C.S., of Royal Perth Hospital, Perth, Australia reviewed the medical records of 60 patients (55 men and five women, average age 47.5) who underwent sleep apnea surgery to treat obstructive sleep apnea between 2002 and 2006.
The procedure, Transpalatal Advancement Pharyngoplasty, aims to address the airway obstruction and create a larger space in the area behind the roof of the mouth.
“Patients with obstructive sleep apnea who cannot tolerate or refuse CPAP therapy may be considered for surgical treatment,” write Drs. Shine and Lewis.
Transpalatal Advancement Pharyngoplasty Study Criteria
All participants underwent sleep testing before and after the sleep apnea surgery with the success or benefit of the Transpalatal Advancement Pharyngoplasty being measured by the increase in monitored levels of arterial oxygen concentrations and the decrease in the number of sleep disturbances following the surgery compared to pre-op conditions.
Study Results
The research considered that the Transpalatal Advancement Pharyngoplasty procedure was successful in 38 of the 60 patients (63 percent) with obstructive sleep apnea. Sleep apnea was determined to have been completely cured in 21 patients (35 percent).
Interestingly, no associations were found between disease severity or obesity and the success of transpalatal advancement pharyngoplasty surgery, indicating that it is potententially difficult to predict which patients will respond to this type of sleep apnea surgery.
Study Conclusions
The researchers concluded “To our knowledge, this is the largest series reported to date regarding the transpalatal advancement pharyngoplasty procedure,” and that “It should be considered in patients in whom conservative management has failed and who are willing to undergo sleep apnea surgery to improve the retropalatal airway.”
The research adds to previous studies and general experience that the success of sleep apnea surgery is not certain but that it remains a viable alternative to other forms of treatment.