Giampiero Gulotta1, Giannicola Iannella2, Giuseppe Meccariello2, Giovanni Cammaroto2, Irene Claudia Visconti3, Marco de Vincentiis4, Antonio Greco5, Stefano Pelucchi6, Giuseppe Magliulo3, Giovanni Ruoppolo7, Antonino Maniaci8, Salvatore Cocuzza9, Ignazio La Mantia10, Andrea De Vito11, Pietro Abita12, Claudio Vicini13. 1. Department of "Organi di Senso", Sapienza University of Rome, Viale del Policlinico, 151-00161 Rome, Italy. Electronic address: giampierogulotta@gmail.com. 2. Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Via Carlo Forlanini, 34-47121 Forlì, Italy. 3. Department of "Organi di Senso", Sapienza University of Rome, Viale del Policlinico, 151-00161 Rome, Italy. 4. Department of "Organi di Senso", Sapienza University of Rome, Viale del Policlinico, 151-00161 Rome, Italy. Electronic address: marco.devincentiis@uniroma1.it. 5. Department of "Organi di Senso", Sapienza University of Rome, Viale del Policlinico, 151-00161 Rome, Italy. Electronic address: antonio.greco@uniroma1.it. 6. Ear-Nose-Throat & Audiology Unit, University of Ferrara, 44121 Ferrara, Italy. Electronic address: stefano.pelucchi@unife.it. 7. Department of "Organi di Senso", Sapienza University of Rome, Viale del Policlinico, 151-00161 Rome, Italy. Electronic address: giovanni.ruoppolo@uniroma1.it. 8. Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", Ear, Nose, Throat Section, University of Catania, Catania, Italy. 9. Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", Ear, Nose, Throat Section, University of Catania, Catania, Italy. Electronic address: scocuzza@unict.it. 10. Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", Ear, Nose, Throat Section, University of Catania, Catania, Italy. Electronic address: ilamantia@unict.it. 11. Head&Neck Department, Ear Nose Throat (ENT) Unit, Santa Maria delle Croci Hospital, Romagna Health Company, 48121 Ravenna, Italy. 12. Unit of Otorhinolaringology, Department of Adult and Development Age Human Pathology "Gaetano Barresi", University of Messina, Messina, Italy. 13. Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Via Carlo Forlanini, 34-47121 Forlì, Italy; Ear-Nose-Throat & Audiology Unit, University of Ferrara, 44121 Ferrara, Italy. Electronic address: claudio@claudiovicini.com.
Abstract
PURPOSE: Analyze Extrusion&Exposion (E&E), its implications in the functional, anatomical results and subjective discomfort in OSA patients treated with Barbed Reposition Pharyngoplasty (BRP). MATERIALS AND METHODS: 488 patients treated with BRP or multilevel TORS. Stratafix wire was used in 230 patients, V-Loc in 258. E&E, timing and localization evaluated at follow-up. Polygraphy used to assess the impact of E&E on functional results, PPOPS questionnaire used for subjective discomfort. RESULTS: E&E in the entire group was 18,4%, with significant difference between Stratafix and V-Loc wire (p = 0,002), but not between BRP alone and multilevel surgery (p = 0,68). 28,9% of extrusion happened within the first seven days, 76,7% between seven days and two months, 5,5% after two months. Symptomatic clinical profile has been seen in 62,2%, asymptomatic one in 37,8% of patients. 35,5% of E&E were localized in tonsillar bed, 46,7% in soft palate and 20% in other sites. Mean delta-AHI of E&E patients was -15,87 ± 16.82 compared with one of those who did not have E&E was -16.34 ± 22,77 (p = 0,38). Mean PPOPS of 183 patients analyzed was 12,32 ± 4,96. Mean PPOPS of extruded group was 12,94 ± 4,68 and 11,92 ± 5,11 in not extruded one (p = 0,166). CONCLUSIONS: E&E are suture-type sensitive (V-Loc > Stratafix), reported more frequent when BRP is performed alone than BRP-TORS with no statistical significance. 76,7% of the E&E occur after patient discharge and within 2 months. About half of the E&E were localized in soft palate. There is no need to fear Extrusion&Exposition because it does not affect in a negative way subjective and PSG outcome.
PURPOSE: Analyze Extrusion&Exposion (E&E), its implications in the functional, anatomical results and subjective discomfort in OSA patients treated with Barbed Reposition Pharyngoplasty (BRP). MATERIALS AND METHODS: 488 patients treated with BRP or multilevel TORS. Stratafix wire was used in 230 patients, V-Loc in 258. E&E, timing and localization evaluated at follow-up. Polygraphy used to assess the impact of E&E on functional results, PPOPS questionnaire used for subjective discomfort. RESULTS: E&E in the entire group was 18,4%, with significant difference between Stratafix and V-Loc wire (p = 0,002), but not between BRP alone and multilevel surgery (p = 0,68). 28,9% of extrusion happened within the first seven days, 76,7% between seven days and two months, 5,5% after two months. Symptomatic clinical profile has been seen in 62,2%, asymptomatic one in 37,8% of patients. 35,5% of E&E were localized in tonsillar bed, 46,7% in soft palate and 20% in other sites. Mean delta-AHI of E&E patients was -15,87 ± 16.82 compared with one of those who did not have E&E was -16.34 ± 22,77 (p = 0,38). Mean PPOPS of 183 patients analyzed was 12,32 ± 4,96. Mean PPOPS of extruded group was 12,94 ± 4,68 and 11,92 ± 5,11 in not extruded one (p = 0,166). CONCLUSIONS: E&E are suture-type sensitive (V-Loc > Stratafix), reported more frequent when BRP is performed alone than BRP-TORS with no statistical significance. 76,7% of the E&E occur after patient discharge and within 2 months. About half of the E&E were localized in soft palate. There is no need to fear Extrusion&Exposition because it does not affect in a negative way subjective and PSG outcome.