Barbed stayed bridge pharyngoplasty (BSBP)

Obstructive sleep apnea (OSA) is a chronic disease characterized by recurrent episodes of upper airway collapse and obstruction of the upper airways during sleep. The gold standard of treatment is continuous positive airway pressure (CPAP), with limited long-term patient compliance.1 Velo-pharyngeal surgery is a validated treatment option for OSA patients diagnosed with retrovelar and oropharyngeal collapse. Vicini first proposed the Barbed Reposition Pharyngoplasty (BRP) technique,2 using barbed sutures to increase the cross section of the retropalatal area and oropharyngeal inlet, stiffening the pharyngeal lateral wall. This mini-invasive technique requires the removal of the “fat pad” area and a section of the palatopharyngeal muscle (PPM) in their inferior portion. Continuous solicitation of a single vector during palatal activities may weaken the system, inducing a recurrence of pharyngeal collapse. Reoperation is not easy since the PPM has been transected. Therefore, the authors propose a modified BRP called Barbed Stayed Bridge Pharyngoplasty (BSBP).