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Barbed pharyngoplasty for the treatment of obstructive sleep apnea: the surgical learning curve

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Background

Barbed snore surgery (BSS) was recently introduced for the management of obstructive sleep apnea (OSA) with optimistic clinical outcomes associated with a low complication rate. The purpose of the present study was to describe the surgical learning curve of the BSS to determine the effect of surgeon experience on surgical procedure time and complication rates.

Methods

Patients who underwent tonsillectomy with barbed lateral pharyngoplasty were divided in two different groups based on surgeon experience. Operative time, intraoperative blood loss, intra- and post-operative complications, and hospitalization time were compared.

Results

A total of 144 consecutive patients (F: 27; mean age: 47.5 years, SD 9.7) were included. All procedures were successfully completed in 37.0 min (IQR 29.0–47.0). Senior surgeons completed the procedure in 33.0 min (IQR 27.0–41.0), while junior surgeons needed 52.0 min (IQR 36.5–64.5) (p < .05). No intra-operative complications were observed, and intra-operative blood loss was minimal in both groups. No difference was measured in terms of hospitalization time. Only one post-operative bleeding resolved with conservative treatment was detected in both groups. Junior surgeons showed a positive trend in the reduction of operative time (r =  − 2.32, 95% CI: − 2.74 to − 1.90; p < .05).

Conclusions

The findings suggest that BSS may be safely performed by inexperienced surgeons with no increased risk of intra- and post-operative complications. The surgical LC is short and the junior surgeon can reach the ability of senior surgeons after a few number of procedures with a progressive reduction of the operative time.

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Data availability

The data that support the findings of this study are available on reasonable request from the corresponding author.

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Authors and Affiliations

  1. Unit of Otorhinolaryngology–Head and Neck Surgery, Humanitas San Pio X, Via Francesco Nava, 31, 20159, Milan, Italy

    Federico Leone, Silvia De Santi, Giulia Anna Marciante, Alessandro Bianchi, Giovanni Colombo & Fabrizio Salamanca

  2. Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy

    Andrea Costantino, Giovanni Colombo & Fabrizio Salamanca

  3. Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy

    Andrea Costantino

Authors
  1. Federico Leone
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  2. Silvia De Santi
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  3. Andrea Costantino
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  4. Giulia Anna Marciante
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  5. Alessandro Bianchi
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  6. Giovanni Colombo
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  7. Fabrizio Salamanca
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Corresponding author

Correspondence to Federico Leone.

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Ethics approval and consent to participate

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional local committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. All patients included in this study signed an informed consent.

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All authors declare that they have no conflict of interest.

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Level of evidence

Level V.

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Leone, F., De Santi, S., Costantino, A. et al. Barbed pharyngoplasty for the treatment of obstructive sleep apnea: the surgical learning curve. Sleep Breath 26, 1869–1874 (2022). https://doi.org/10.1007/s11325-022-02579-1

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  • DOI: https://doi.org/10.1007/s11325-022-02579-1

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