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- Title
Expansion sphincter pharyngoplasty in the treatment of obstructive sleep apnea: case report.
- Authors
Martins de March, Enzo; Gardin dos Santos, Jamile; Graziela Dal Vesco, Karin; Kenji Sakai, Lucas; Gil, Isabella; Genero Pizzatto, Lais
- Abstract
Introduction: Obstructive sleep apnea is a multifactorial disease characterized by airway collapse during sleep with reduced oxygen saturation. Structural and functional factors are involved, such as reduced expansion forces of the pharyngeal dilator muscles, soft tissue disorders, macroglossia and hypertrophy of palatine tonsils. The treatment encompasses clinical and surgical modalities that aim to reduce cardiovascular consequences. The surgical technique is based on tonsillectomy and resection of redundant supratonsillar tissue of the soft palate, followed by sutures that unite the palatopharyngeal, superior constrictor and palatoglossus muscles, with reduced soft tissue collapse. Objectives: To report a case of obstructive sleep apnea treated with expansion spincter pharyngoplasty. Resumed report: Male, 29 years old, class 3 obesity, complains of unrefreshing sleep, insomnia, daytime tiredness and snoring. Epworth sleepiness Scale scored 21. On physical examination, patient with body mass index 40.6, grade 4 palatine tonsils, webpalate and elongated uvula. Type 4 polysomnography, called biologix, was performed, which showed an oxygen desaturation index of 108/hour. Patient submitted to expansion sphincter pharyngoplasty. A new polysomnography was performed in the immediate postoperative period, with an oxygen desaturation index of 52/hour. He was discharged from hospital with CPAP titration and outpatient return for followup. Conclusion: Expansion spincter pharyngoplasty is able to reduce the apnea index and improve oxyhemoglobin saturation, reducing cardiac overload during sleep. Therapeutic success consists of individualizing each patient, sometimes requiring the association of clinical therapy.
- Subjects
SLEEP apnea syndromes; TONSILLITIS; SPHINCTERS; FATIGUE (Physiology); HOSPITAL admission &; discharge; SOFT palate
- Publication
International Archives of Otorhinolaryngology, 2022, Vol 26, p31
- ISSN
1809-9777
- Publication type
Case Study