Barbed suspension pharyngoplasty for treatment of lateral pharyngeal wall and palatal collapse in patients affected by OSAHS

  • Marco Barbieri
  • Francesco MissaleEmail author
  • Fabiola Incandela
  • Marco Fragale
  • Andrea Barbieri
  • Valeria Roustan
  • Frank Rikki Canevari
  • Giorgio Peretti



The aim of this study is to analyze the efficacy of a new modified pharyngoplasty technique with barbed sutures: barbed suspension pharyngoplasty (BSP).


We enrolled patients affected by obstructive sleep apnea–hypopnea syndrome (OSAHS), having the main site of obstruction at the palatal and lateral pharyngeal walls, who refused or failed to tolerate CPAP therapy and underwent non-resective pharyngoplasty with barbed sutures between January 2014 and October 2017. Two surgical techniques with barbed sutures were used: barbed reposition pharyngoplasty (BRP) and BSP; the main characteristics of the latter are a double passage of the needle, each side, through the soft palate.


Forty-two patients met the study inclusion criteria and were included in the analysis. Twenty-two patients underwent BRP and 20 BSP. Patients treated with both BRP and BSP achieved significant improvement in polysomnographic parameters: AHI, ODI, t90%, and daily sleepiness tested by the ESS questionnaire (p < 0.001). There were no significant differences between groups considering gender, age, or severity of OSAHS (p > 0.05). Outcomes were also comparable (p = 0.10) in the two groups; patients who underwent BSP had successful treatment in 100% of cases, compared to 86% with BRP, with a cure rate of 40% vs. 18%.


BSP is a novel surgical technique that is effective in treating oropharyngeal collapse and can be tailored for patients with high collapsibility of the soft palate who might benefit from the palatal stiffness given by multiple passages of the suture inside it.


Sleep apnea OSA Pharyngoplasty Barbed Surgery Outcome 



None of the authors have any commercial interest in the subject of this study or received any financial or material support for this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The research did not involve any animal models; the research involved human participants in accordance with the ethical standards of the institutional and/or national research committees and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards; and informed consent was obtained from all individual participants included in the study. Ethical review and approval was not required for this study in accordance with the national and institutional requirements (Ethics committee IRCCS Ospedale Policlinico San Martino, Genoa). However, all patients preoperatively signed a consent form for disclosure of privacy in managing personal data for scientific purposes.

Supplementary material

Supplementary file1 (MOV 37446 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.IRCCS Ospedale Policlinico San MartinoGenoaItaly
  2. 2.Department of Otorhinolaryngology, Head and Neck SurgeryUniversity of GenoaGenoaItaly
  3. 3.Department of Otorhinolaryngology, Maxillofacial and Thyroid SurgeryFondazione IRCCS, National Cancer Institute of Milan, University of MilanMilanItaly
  4. 4.Department of OtorhinolaryngologyOspedale Santa Maria Delle CrociRavennaItaly

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