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Evolution of Palatal Surgery for Sleep-Disordered Breathing

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Barbed Pharyngoplasty and Sleep Disordered Breathing

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Abstract

Uvulopalatopharyngoplasty (UPPP) was the first palatal surgery specifically developed for snoring and obstructive sleep apnea (OSA). To date, palatal surgery remains the paragon among various sleep surgeries and is the most commonly used surgery for OSA. During past decades, palatal surgery has evolved from the traditional UPPP, minimally invasive palatal surgery, to a functional reconstruction of the lateral pharyngeal wall and soft palate. The advancement of palatal surgery over the past 40 years has been a multi-dimensional evolution involving the concepts, surgical techniques, and postoperative care in treating sleep-disordered breathing (SDB). Conceptual evolution includes refinements of surgical indications, assessments of obstruction sites, and surgical limitations pertinent to clinical outcomes. Technical evolution comprises the suspension of muscle to maximize the velopharyngeal airspace and hybrid procedure to minimize the complications. Evolved postoperative care ensures better recovery after surgery and integrated treatment. In order to achieve comprehensive safety and efficacy in treating SDB patients, palatal surgery addressing the velopharyngeal obstruction continues to evolve.

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Acknowledgments

The author would like to express the deepest gratitude to Linkou-Chang Gung Memorial Hospital for long-term support by grants in our sleep research. The authors also thank Dr. Yi-Chan Lee, Dr. Chien-Han Tsao, and Dr. Ying-Shuo Hsu for their extensive consultation to this chapter.

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, Sleep Center, Linkou Chang Gung Memorial Hospital, Taoyuan City, Taiwan

    Hsueh-Yu Li & Li-Ang Lee

  2. School of Medicine, Chang Gung University, Taoyuan City, Taiwan

    Hsueh-Yu Li, Li-Ang Lee & Ming-Shao Tsai

  3. Department of Otolaryngology—Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan

    Ming-Shao Tsai

  4. Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Ming-Shao Tsai

  5. Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi, Taiwan

    Ming-Shao Tsai

  6. Department of Otolaryngology-Head and Neck Surgery, New Taipei Municipal Tucheng Hospital, New Taipei City, Taiwan

    Shih-Chieh Shen

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  1. Hsueh-Yu Li
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  2. Li-Ang Lee
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  4. Shih-Chieh Shen
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Corresponding author

Correspondence to Hsueh-Yu Li .

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Editors and Affiliations

  1. Department of Otolaryngology and Head-Neck Surgery, Morgagni-Pierantoni Hospital, Forlì, Italy

    Claudio Vicini

  2. Department of Otolaryngology and Head-Neck Surgery, Humanitas University, Milan, Italy

    Fabrizio Salamanca

  3. Department of ‘Organi di Senso’, University “Sapienza”, Rome, Italy

    Giannicola Iannella

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Li, HY., Lee, LA., Tsai, MS., Shen, SC. (2022). Evolution of Palatal Surgery for Sleep-Disordered Breathing. In: Vicini, C., Salamanca, F., Iannella, G. (eds) Barbed Pharyngoplasty and Sleep Disordered Breathing. Springer, Cham. https://doi.org/10.1007/978-3-030-96169-5_1

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  • DOI: https://doi.org/10.1007/978-3-030-96169-5_1

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