Surgical correction of lateral pharyngeal wall collapse in sleep related disordered breathing: functional expansion pharyngoplasty

The recent evolution regarding the techniques of pharyngoplasty has been focused on the concept of obtaining the expansion and stabilization of the pharyngeal airspace through the treatment of lateral pharyngeal wall (LPW) collapse rather than through ablation of the redundant pharyngeal soft tissue. The role of LPW in the pathogenesis of obstructive sleep apnea syndrome has been demonstrated by radiologic and sleep endoscopy studies and the narrowing of the LPW appears to be the sole independent risk factor for obstructive sleep apnea syndrome. The functional expansion pharyngoplasty represents a conservative modification of expansion sphincter pharyngoplasty and can be used in patients with obstruction of the upper airway due to the LPWs collapse without altering physiological functions of the upper airway, including smell, taste, swallowing, and speech.