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Lateral pharyngoplasty vs. traditional uvulopalatopharyngoplasty for patients with OSA: systematic review and meta-analysis

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Abstract

Objectives

To compare the efficacy and success rates of lateral pharyngoplasty techniques (LP) vs. uvulopalatopharyngoplasty (UPPP) among adult patients surgically treated for obstructive sleep apnea.

Methods

A systematic literature review of the last 20 years’ papers was conducted using PubMed/Medline, Embase, Web of Science, Scholar, and the Cochrane Library until April 2021. Only full-text English articles comparing LP and UPPP outcomes in adult patients with objective outcomes were included in the study.

Results

We included 9 articles for a total of 312 surgically treated patients with OSA. LP techniques for obstructive sleep apnea were used on 186 (60%) subjects, while 126 patients (40%) were treated with UPPP. Both surgical procedures resulted in significant improvements in apnea-hypopnea index (AHI), Epworth Sleepiness Scale (ESS) score, and lowest oxygen saturation (LOS) (p < 0.001 in all cases). Although better outcomes were reported with lateral pharyngoplasty, the differences were not significant compared to UPPP post-operative results (p > 0.05 in all cases).

Conclusions

UPPP and LP are both effective surgical procedures in treating OSA in adults. Although not significant, LPs demonstrated improved post-operative outcomes. However, further evidence comparing the surgical effect on patients with OSA is needed to discriminate post-operative outcomes.

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Data availability

The authors confirm that the data supporting the findings of this study are available within the article.

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Acknowledgements

We thank Professor Antony Bridgewood for the significant guidance provided during the drafting of the manuscript.

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Author notes

  1. Jerome René Lechien

    Present address: Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium

Authors and Affiliations

  1. Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia,” ENT Section, University of Catania, Via Santa Sofia, 95100, Catania, Italy

    Antonino Maniaci, Milena Di Luca, Calogero Grillo, Caterina Maria Grillo, Federico Merlino, Salvatore Cocuzza, Vittoria Bannò, Isabella Pollicina, Giovanna Stilo & Ignazio La Mantia

  2. Department of Head-Neck Surgery, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì, Italy

    Giannicola Iannella, Andrea De Vito & Claudio Vicini

  3. Department of Sensory Organs, Sapienza University of Rome, Rome, Italy

    Giannicola Iannella, Giuseppe Magliulo & Annalisa Pace

  4. Service of Otolaryngology, Hospital Complex of Santiago de Compostela, s/n. 15706, Santiago de Compostela, Spain

    Christian Calvo-Henriquez

  5. Department ENT and Audiology, University of Ferrara, Ferrara, Italy

    Claudio Vicini

  6. Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123, Catania, CT, Italy

    Alberto Bianchi

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  1. Antonino Maniaci
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Correspondence to Antonino Maniaci.

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All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Maniaci, A., Di Luca, M., Lechien, J.R. et al. Lateral pharyngoplasty vs. traditional uvulopalatopharyngoplasty for patients with OSA: systematic review and meta-analysis. Sleep Breath 26, 1539–1550 (2022). https://doi.org/10.1007/s11325-021-02520-y

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