Outcome measures:
- A subjective measure of NPS by upper airways endoscopy and oral cavity
exploration.
- Baseline, 4weeks, 3months, and 1-year Visual Analog Scale (VAS 0–10)
for nasal breathing, snoring by bed partner,and dysphagia (0 “no
complaints” to 10 “severe complaint”).
- Baseline and 1-year follow-up polysomnography.
- Short term morbidity and adverse events especially VPI.
Surgical technique (figure 1,2)Under general anaesthesia and patient’ssupine position, mouth gag was
inserted. The operative site was infiltrated with 1% lidocaine with
1:100,000 epinephrine solution.A butterfly mucosal flaps were
designed, marked, elevated and removed from the oral surface of the
soft palate with caution to preserve the soft palate nasal mucosa.
Then, the soft palate was divided in the midline paying attention not
to injure the posterior pharyngeal wall mucosa. Excessive soft palate
scar tissue was removed as required to facilitate eversion and
suturing of the nasal mucosal surface to the oral side. Vicryl suture
was placed on the edge of each side of the divided palate to
facilitate its eversion. The closure was done in a centrifugal
direction by vicryl in 2 layers; 1st one is
submucosal inverted sutures and 2nd one is
horizontal mattress mucosal sutures without tension and keeping the
stitches on the oral side, not on theedge.By this way, we aim to
change the scar contracture tension lines to anterolateral vectors and
to widen the anteroposterior and lateral oropharyngeal air spaces at
palatal level.
All patients received postoperative paracetamol, antibiotics and
steroids, and asked to maintain on soft diet and fluids for 2 weeks.
TheSPSS program version 20 (Chicago, Illinois, USA) was used for
statistical analysis. P-value <0.05 was considered
significant.