Acute effects of palatopharyngoplasty on airway collapsibility.

Abstract

The lateral pharyngeal walls contribute to obstruction in obstructive sleep apnea. These structures may be unaffected by uvulopalatopharyngoplasty. This was evaluated by retrospective review of upper airway observations after palatopharyngoplasty. The retropalatal airway was endoscopically observed intraoperatively after each procedure in 7 patients. The airway was dilated with nasal continuous positive airway pressure. Transpalatal advancement pharyngoplasty increased the area 120% (P = 0.001), and closing pressure decreased 9.2 cm H2 O (P < 0. 01). The maximal anteroposterior length (MAX-AP) and maximal lateral radius increased 90% (P = 0.01) and 60% (P < 0.001), respectively. MAX-AP changed in 2, both increased in 4, and maximal lateral radius increased in 1 patient. The closing pressure change correlated with airway size (r 2 = 0.44, P < 0.05); airway shape was associated with change in MAX-AP (r 2 = 0.51, P < 0.07). Both the anteroposterior and lateral wall dimensions are altered by palatopharyngoplasty techniques, which increase retropalatal airway size. This is not limited to facial advancement surgery.