Changes in airway characteristics after transpalatal advancement pharyngoplasty compared to uvulopalatopharyngoplasty (UPPP).

Transpalatal advancement pharyngoplasty is postulated to enlarge the retropalatal airway compared to uvulopalatopharyngoplasty (UPPP) for treatment of the obstructive sleep apnea syndrome (OSAS). Surgical success in treating OSAS has been associated with increasing size and decreasing collapsibility of the retropalatal airway to prevent airway obstruction. To compare transpalatal advancement pharyngoplasty compared to UPPP, upper airway characteristics were measured following each procedure in seven patients using a quantitative endoscopic technique. Following transpalatal advancement pharyngoplasty, maximal retropalatal airway size increased 220% from 61.5 to 135.0 mm2 (p < 0.001), and retropalatal closing pressure decreased 9.2 cm H2O from 5 to -4.2 cm/H2O (p < 0.001) compared to UPPP. Results demonstrate that transpalatal advancement pharyngoplasty significantly increases retropalatal size and decrease retropalatal collapsibility compared to UPPP. Since these characteristics contribute to increased stability, transpalatal advancement pharyngoplasty may improve traditional UPPP. Studies of airway mechanics may assist in improving surgical treatment of OSAS.