Positive airway pressure is the treatment of choice among obstructive sleep apnea syndrome patients.
Among surgical options, multilevel approach is a good option in patients with an involvement of all tract
of first airway. The aim of the present work is to establish the efficacy of anterior palatoplasty in the
treatment of selected patients with mild obstructive sleep apnea syndrome or simple snoring, within a
multilevel surgery. The group was composed of 16 mild obstructive sleep apnea syndrome adult patients
collected from January 2015 to June 2016 at University of Palermo, Ear, Nose and Throat Department. To
make diagnosis of obstructive sleep apnea syndrome, we employed polysomnography, the Epworth
Sleepiness Scale and an endoscopic study of aerodigestive tract in order to identify the sites of collapse.
All patients underwent to inferior turbinate reduction, anterior pharyngoplasty and hyoid suspension. After
treatment, 11 patients had Apnea Hypopnea Index ≤5 and 4 patients less than 50% compared to the
starting one. According to Epworth Sleepiness Scale, the daytime sleepiness enhanced from 12.6 to 8.6
post-operative average. Pre-operative mean value of Muller’s maneuver was N (nose):2.6, O (oropharinx):
3.4, H (hypopharinx):2.5 Before performing surgical procedure each patient was subjected to sleep
endoscopy to evaluate better the pattern of collapse. The post-operative mean outcomes of Mueller’s
Maneuver was: N 1.5, O 1.3, H 1.3. Barbed Anterior pharyngoplasty, combined with other surgical
procedures, can be considered a valid surgical option to relieve snoring, and mild apnoic events. Our
preliminary results, show that the anterior palatoplasty, combined with other surgical procedures, can be
considered a valid surgical option to relieve snoring and mild apnoic events.