Expansion sphincter pharyngoplasty an alternate option for treatment of Sleep Apnea

A recent study found that Expansion sphincter pharyngoplasty (ESP) can be an alternate option for patients with Obstructive Sleep Apnea. This is especially a better option for eligible patients who cannot tolerate Continuous positive airway pressure (CPAP). The study was published in the journal Otolaryngology-Head and Neck Surgery. 

Obstructive sleep apnea (OSA) is a common progressive chronic disorder with increased comorbidities. The mainstay of management of OSA is Continuous positive airway pressure (CPAP). But patient adherence to CPAP is not great. Another treatment option for OSA is Expansion sphincter pharyngoplasty (ESP). ESP can be used in patients having signs of lateral pharyngeal collapse. Researchers conducted a retrospective study from 2019 to 2021 to compare the outcomes of patients who underwent ESP with those undergoing CPAP therapy.  The mean disease alleviation concept was the main basis of comparison.  

Patients diagnosed with OSA who underwent ESP or were prescribed CPAP were assessed for inclusion. ESP patients having pre- and postoperative sleep studies, and CPAP patients who were followed up at the sleep clinic and had smartcard data available for review were included for analysis. Charts were reviewed for demographic information. Sleep study results and treatment outcomes were measured by calculating mean disease alleviation. Significance was assessed using the Welch t-test and t-test analyses. 

 Results:

• 57 patients in the ESP group and 54 patients in the CPAP group participated in the study.
• The mean pretreatment apnea-hypopnea index (AHI) was similar between groups (P=.73).
• AHI reduction was greater in the CPAP group but, the mean disease alleviation was 48.0 for the ESP group and 49.9 for the CPAP group.
• Residual AHI was 17.5 and 17.4 for the ESP and CPAP groups respectively (P=.97). 

Thus, the researchers concluded that even though CPAP therapy provided a better reduction in AHI when compared with ESP, overall treatment efficacy as measured by mean disease alleviation was similar for both groups. Hence, they suggested ESP may be used as an effective treatment option for eligible patients who cannot tolerate CPAP. 

To read the full article, click here: Fiorella M, Armache M, Jamil SB, Boon MS, Huntley CT. Treatment outcomes of expansion sphincter pharyngoplasty versus continuous positive airway pressure Otolaryngol Head Neck Surg. 2022;167(1 suppl): P160.