Barbed Repositioning Pharyngoplasty: Tips and Tricks

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Abstract

The barbed repositioning pharyngoplasty surgical technique is becoming more widely used for patients with obstructive sleep apnea due to its safety, effectiveness, and rapidity, as evidenced by multicenter studies and Meta‐analyses. In order to achieve uniform surgical outcomes, avoid errors that could worsen outcomes, and enable adequate data comparison, a standardized procedure is required to overcome surgeon‐related variability. The aim of this paper is to provide practical tips and tricks based on our surgical practice that can make the surgeon's work easier and aid in achieving desired outcomes.

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Most cited references 5

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Barbed reposition pharyngoplasty (BRP) for OSAHS: a feasibility, safety, efficacy and teachability pilot study. "We are on the giant's shoulders".

Claudio Vicini, Ehsan Hendawy, Aldo Campanini … (2015)

A new palatal procedure for snoring/obstructive sleep apnea (OSA) is described. The procedure was named as barbed reposition pharyngoplasty (BRP). The technique is described step by step. The new surgical technique was carried out in ten adult OSA patients with mean age of 53.4 ± 12.4 years (average 30-70) with confirmed retropalatal obstruction. In this pilot study; we assessed the feasibility by calculating the number of cases that failed to be operated and converted to other palatal technique during the same surgical setting, safety was assessed by evaluating both intra-operative and post-operative complications, teachability measured by the learning curve of our team members (the time of surgical procedure). In this study, the technique is proved to be feasible in all cases. There were no significant intra-operative or post-operative complications. Objective clinical improvement was confirmed by polysomnography 6 months post-operative with significant decrease in mean AHI from 43.65 ± 26.83 to 13.57 ± 15.41 (P = 0.007), daytime sleepiness assessed by Epworth Sleepiness Scale from 11.6 ± 4.86 to 4.3 ± 2 (P < 0.01), ODI from 44.7 ± 27.3 to 12.9 ± 16.3 (P = 0.004). Operative time decreased over the course of the study with an initial steep ascent in technical skill acquisition followed by more gradual improvement, and a steady decrease in operative time to as short as 20 min. Our preliminary results suggest that BRP technique is feasible, safe and effective in management of OSA patients. Moreover, it is easy to learn even for not experienced surgeons, less time consuming and with no significant complications.

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Prospective multicentre study on barbed reposition pharyngoplasty standing alone or as a part of multilevel surgery for sleep apnoea.

F. MONTEVECCHI, G. MECCARIELLO, E. FIRINU … (2018)

The aim of this study was to demonstrate in a prospective multicentre study that Barbed Reposition Pharyngoplasty (BRP) procedure is safe and effective in management of obstructive sleep apnoea/hypopnea syndrome (OSAHS) patients.

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Barbed reposition pharyngoplasty (BRP) in obstructive sleep apnea treatment: State of the art.

Giannicola Iannella, Jerome R. Lechien, Tiziano Perrone … (2021)

In this paper, we perform a systematic review that discusses the state of the art and evolution on the barbed reposition pharyngoplasty (BRP) in the velo-pharyngeal surgery. Clinical evidence and published outcomes of this surgical technique are reported and discussed.

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Author and article information

Contributors

Pierfrancesco Bettini: (View ORCID Profile)

Journal

Title: Otolaryngology–Head and Neck Surgery

Abbreviated Title: Otolaryngol.--head neck surg.

Publisher: Wiley

ISSN (Print): 0194-5998

ISSN (Electronic): 1097-6817

Publication date Created: April 2024

Publication date (Electronic): December 17 2023

Publication date (Print): April 2024

Volume: 170

Issue: 4

Pages: 1204-1207

Affiliations

[1 ] ENT Department Morgagni Pierantoni Hospital Forlì Italy

[2 ] ENT and Audiology Department University of Ferrara Ferrara Italy

[3 ] ENT Department La Sapienza University Rome Italy

Article

DOI: 10.1002/ohn.626

PubMed ID: 38104315

SO-VID: 864960f8-5402-4385-b2b8-177a84e68120

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http://onlinelibrary.wiley.com/termsAndConditions#vor

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