Outcomes of expansion sphincter pharyngoplasty in multilevel lateral pharyngeal wall collapse in obstructive sleep apnea

Esraa Moustafa, resident of Otorhinolaryngology, Mansoura University, EgyptFollow
Hisham Atef Ebada, assistant professor of Otorhinolaryngology, Mansoura University, Egypt
Ahmed El-sobki, professor of Otorhinolaryngology, Mansoura University, Egypt
Mohamed Mostafa Elsaher, professor of Otorhinolaryngology, Mansoura University, Egypt

Subject Area

Otolaryngology

Article Type

Original Study

Abstract

Background: since its introduction in 2006, Since its introduction, expansion sphincter pharyngoplasty (ESP) has demonstrated significant efficacy in the management of pharyngeal collapse among patients with obstructive sleep apnea syndrome (OSAS). The aim of the current study is to investigate the effectiveness of ESP in multi-level pharyngeal wall collapse in patients with OSAS. Methods: This prospective study was conducted in the Otorhinolaryngology Department, Faculty of Medicine, Mansoura University, Egypt over 1.5 years (June 2023 – December 2024). The study included 29 patients with OSAS who underwent ESP to manage multilevel pharyngeal wall collapse. The outcomes were evaluated based on the apnea–hypopnea index (AHI) and minimum oxygen saturation obtained from polysomnographic recordings, as well as the visual analogue scale (VAS) for snoring and the Epworth Sleepiness Scale (ESS). Results: Postoperative evaluation at six months demonstrated significant improvement in all parameters. The mean AHI decreased from a preoperative value of 35.42 ± 7.36 to 18.03 ± 5.58 postoperatively (p = 0.001). Similarly, minimum oxygen saturation showed a marked improvement, rising from a baseline of 70.03 ± 7.63 to 91.95 ± 4.11 after surgery (p = 0.001). Snoring severity, assessed using VAS, improved from 7.01 ± 1.61 preoperatively to 3.63 ± 1.37 (p = 0.001). In addition, the ESS score significantly decreased from 16.39 ± 3.49 to 9.02 ± 3.56 postoperatively (p = 0.001). Based on Sher’s criteria, the overall surgical success rate was 86.2%. Twenty-five of the 29 patients achieved a reduction in AHI greater than 50%, with a postoperative AHI below 20. Conclusion: Expansion sphincter pharyngoplasty is an effective surgical technique for managing OSAS resulting from multilevel lateral pharyngeal wall collapse involving the soft palate, oropharynx, and hypopharynx. It is considered a safe procedure, associated with minimal postoperative pain and low morbidity rates.

Recommended Citation

Moustafa, Esraa; Ebada, Hisham Atef; El-sobki, Ahmed; and Elsaher, Mohamed Mostafa (2025) "Outcomes of expansion sphincter pharyngoplasty in multilevel lateral pharyngeal wall collapse in obstructive sleep apnea," Mansoura Medical Journal: Vol. 54 : Iss. 4 , Article 16.
Available at: https://doi.org/10.58775/2735-3990.1485