460 Alianza Barbed Pharyngoplasty in Moderate to Severe OSAS Patients
Abstract Introduction Alianza barbed pharyngoplasty is a recent non-resective surgical tecnique, indicated for patients with obstructive sleep apnea syndrome (OSAS) with circular retropalatal obstruction pattern. It has the aim of stabilizing and reducing the collapsibility of the palato-pharyingeal area during sleep. It uses barbed absorbable sutures that allow to suspend palato-pharyngeal structures to anatomical non-collapsable landmarks (posterior nasal spine, pterigoideal hamulus, pterigomandibular raphe). The aim of this study is to evaluate efficacy and safety of Alianza barbed pharyngoplasty in moderate to severe OSAS. Methods Thirty-six consecutive patients with moderate to severe OSAS underwent Alianza barbed pharyngoplasty. Preoperatively all patients presented with palatal hypertrophy, concentric collapse and retropalatal flatter during drug induced sleep endoscopy (DISE) and did not tolerate CPAP and/or MAD therapies. All patients underwent clinical examination, polysomnography, and subjective evaluation of snoring with visual analogue scale (VAS) and Epworth Sleepiness Scale (ESS) both pre-operatively (T0) and at 6 months postoperatively (T1). Results There was a significant reduction of AHI at T1, from 32.49 ± 14.55 to 12.1 ± 12.16 (p< 0.05) of AHI. Mean AHI gain was of 20.39 ± 11.58, in particular 13.34 ± 5.48 in moderate OSAS patients and 30.18 ± 9.34 in severe OSAS patients. There was also a significant ODI reduction, from 27.57 ± 15.68 to 12.97 ± 13.25 (p< 0.05). There was a significant reduction of ESS, from 8.75 ± 4.51 to 4.05 ± 2.39 (p< 0.05) and a significant reduction of snoring VAS from 7.85 ± 1.23 to 3.2 ± 1.7 (p< 0.05). Conclusion Alianza barbed pharyngoplasty led to significant improvement both in objective parameters measured with polysomnography (AHI and ODI), and in subjective parameters (ESS and snoring VAS) in moderate to severe OSAS patients. Support (if any):