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Pharyngoplasty

Excessive soft palate tissue is a frequent cause of airway obstruction in obstructive sleep apnea. The most common procedure to treat the soft palate is a uvulopalatopharyngoplasty. Uvulopalatopharyngoplasty is a procedure in which tissue from the palate and/or the back of the throat is removed to increase airway size. However, there are potential significant complications, such as foreign body sensation — a feeling that something is in the back of the throat while swallowing — and velopharyngeal insufficiency — liquids or food escape into the nose while drinking or eating.

Pharyngoplasty is a significantly less invasive procedure that also achieves improvement of the airway. In this procedure, a minimal amount of tissue is removed as compared to uvulopalatopharyngoplasty or uvolopalatal flap. Tonsillectomy is routinely performed in pharyngoplasty and airway improvement results from tissue rearrangement by suturing the tissue laterally and superiorly.

This procedure is performed in a hospital surgery center under general anesthesia.

This procedure takes approximately one hour. Overnight hospitalization is usually recommended afterward, and in general the patient can usually return to work in 10 to 14 days.

Since minimal tissue is removed during pharyngoplasty, it is associated with less pain and complications than uvulopalatopharyngoplasty or uvulopalatal flap. However, post-operative pain can still be significant, especially when combined with a tonsillectomy. Bleeding represents another potential but uncommon complication.

This procedure is often performed in conjunction with nasal surgery, genioglossus advancement or radiofrequency reduction of the tongue in order to maximize airway improvement.

Before Surgery
During Surgery
Before Surgery
During Surgery
after surgury
After Surgery

 

References:

Li KK, Powell NB, Riley RW, Troell RJ, Guilleminault C.  Overview of Phase I Surgery for Obstructive Sleep Apnea Syndrome.  Ear Nose and Throat Journal; 78(11):836-845, 1999.

Guilleminault C, Kim Y, Palombini L, Li K, Powell N.  Upper Airway Resistance Syndrome and its Treatment.  Sleep; 23:S197-S200, 2000.

Li KK, Troell RJ, Powell NB, Riley RW, Guilleminault C.  Uvulopalatopharyngoplasty, Maxillomandibular Advancement and the Velopharynx.  Laryngoscope; 111:1075-1078, 2001.

Li HY, Li KK, Chen NH, Wang PC.  Modified Uvulopalatopharyngoplasty: The Extended Uvulopalatal Flap.  American Journal of Otolaryngology; 24:311-316, 2003.

Li HY, Li KK, Chen NH, Wang CJ, Liao YF, Wang PC.  Three-Dimensional Computed Tomography and Polysomnography Findings After Extended Uvulopalatal Flap Surgery for Obstructive Sleep Apnea.  American Journal of Otolaryngology; 26:7-11, 2005.

Li KK, Powell NB, Riley RW.  Surgical Management of Obstructive Sleep Apnea.  In: Lee-Chiong T, Jr., Carskadon MA, Sateia MH, editors.  Sleep Medicine.  Philadelphia, PA, Hanley & Belfus, Inc.  2001.

Li KK.  Surgical Management of Obstructive Sleep Apnea.  Clinics in Chest Medicine; 24:365-370, 2003. 

Li KK.  Obstructive Sleep Apnea – Surgical Treatment.  In: Carney PR, Berry RB, Geyer JD, editors.  Clinical Sleep Disorders. Philadelphia, PA, Lippincott, Williams & Wilkins, 2004.

Li KK.  Surgical Therapy for Obstructive Sleep Apnea Syndrome.  Seminars in Respiratory and Critical Care Medicine; 26:80-88, 2005.

Li KK.  Surgical Therapy for Adult Obstructive Sleep Apnea.  Sleep Med Rev; 9(3): 201-209, 2005. 

Li KK, Guilleminault C.  Adenotonsillectomy in Sleep-Disordered Breathing-What is the Evidence and What are the Implications for Clinical Practice. In: Guilleminault C, editor.  International News on Sleep & its Optimized Management.  2006. 

Li KK.  Pediatric Sleep Apnea-Current Concept in Management.  Sleep Review, 2006.
 

 

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