Uvulopalatopharyngoplasty and Barbed Reposition Pharyngoplasty with and without Hyoid Suspension for treatment of Obstructive Sleep Apnea: A Comparative Study of Functional Results

Al-Tawy, Mohammad Abd Al-Fattah; Hassan, Ahmed Abdelbassit; El-Sharkawy, Mohamed Ahmed; El Shennawy, Ahmed Mohamed

doi:https://doi.org/10.21608/aimj.2025.446653

Uvulopalatopharyngoplasty and Barbed Reposition Pharyngoplasty with and without Hyoid Suspension for treatment of Obstructive Sleep Apnea: A Comparative Study of Functional Results

Document Type : Original Article

Authors

Department of Otorhinolaryngology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt.

https://doi.org/10.21608/aimj.2025.446653

Abstract

Background: Obstructive sleep apnea hypopnea syndrome (OSAHS) is a prevalent disorder impacting 23.4 percent of females and 49.7 percent of males aged forty years.
Aim: To compare the functional results in cases of OSAHS having UPPP, regarding Fairbanks, and barbed reposition pharyngoplasty, regarding Mantovani, without or with hyoid suspension (HS).
Patients and methods: This prospective research included 40 cases that were chosen from cases attended the otolaryngology outpatient clinic in AL-Azhar University Hospitals (Al-Hussein and Sayed Galal University Hospitals), throughout the duration from May 2023 to May 2025. Regarding surgical manipulation of each group: Group (A): cases undergoing UPPP and HS (thyrohyoidopexy), Group (B): cases undergoing UPPP only, Group (C): cases undergoing BRP and HS, Group (D): cases undergoing BRP only.
Results: The analysis of the percentage changes in Oxygen Desaturation Index (ODI), Apnea-Hypopnea Index (AHI), Epworth Sleepiness Scale (ESS), and BMI across four study groups demonstrates statistically significant differences, as evidenced by a p-value below 0.001.
Conclusion: The barbed reposition pharyngoplasty method regarding Mantovani was more efficient than the traditional uvulopalatopharyngoplasty method of Fairbanks for cases of OSAHS. The combined use of hyoid suspension demonstrated higher advantages in Uvulopalatopharyngoplasty than barbed reposition pharyngoplasty. Multilevel surgical procedures (oro and hypopharyngeal) in the operative management of obstructive sleep apnea cases, such as UPPP, BRP, and hyoid bone suspension, are more efficient than a unilevel procedure (UPPP or BRP), as this disorder has multiple levels of obstruction in most cases.

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