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Objectives: Expansion sphincter pharyngoplasty is a well-known palatal correction surgery applied for obstructive sleep apnea patients. Even though high success rates are reported, in some patients, the desired outcome cannot be achieved. Therefore, patient selection is crucial to avoid undesirable outcomes. In this study we present our results with expansion sphincter pharyngoplasty, and we aim to show the difference between supine and non-supine apnea in terms of their response to the surgery, in order to utilize position dependency for selection of surgical candidates.Methods: Pre- and post-operative polysomnography results of patients who underwent expansion sphincter pharyngoplasty were analyzed retrospectively. Total AHI, supine AHI, non-supine AHI, supine/non-supine AHI ratio and surgical success values are compared.Results: 85 patients were included to the study. Mean AHI significantly decreased from 48.7 ± 27.99 to 26.37 ± 21.16 with the surgery. Surgical success rate was found to be 51.8%. Both supine and non-supine apnea decreased significantly with the surgery, but the decrease was significantly higher in non-supine apnea (20.6% to 39.1% respectively, p = 0.016). There was significant negative correlation between pre-operative supine to non-supine AHI ratio and the change in AHI, showing that supine dominant patients had less improvement with the surgery (r = 0.274, p = 0.01).Conclusion: Expansion sphincter pharyngoplasty is an effective surgery which achieves significant improvement in AHI. Non-supine respiratory events respond better to the surgery than supine events. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to determine the effectiveness of coblation midline glossectomy for obstructive sleep apnea (OSA) when used as an isolated procedure. We also aim to compare the effect of this surgical procedure on supine and non-supine apnea.Materials and Methods: The medical records of patients who underwent isolated tongue base surgery as a part of step-wise surgeries between January 2014 and February 2019 are retrospectively reviewed. Pre-operative and post-operative Epworth sleepiness score (ESS), body mass index (BMI), and polysomnographic data, including the apnea-hypopnea index (AHI), oxygen desaturation index (ODI), supine AHI, and non-supine AHI of the patients were compared.Results: The study included 29 patients (26 male and 3 female). AHI improved significantly, decreasing from 34.9 ± 20.9 to 25.8 ± 17.6. Supine AHI decreased from 62.55 ± 28.23 to 55.18 ± 31.67 post-operatively, but this decrease was not significant. Non-supine AHI decreased significantly from 22.49 ± 24.02 to 14.08 ± 17.46. ESS and ODI also improved significantly.Conclusion: Coblation midline glossectomy is an effective surgical procedure when applied solely, with a success rate of 52%. Non-supine apnea benefits to a greater degree than supine apnea from this surgical procedure. [ABSTRACT FROM AUTHOR]