Transpalatal advancement pharyngoplasty and expansion sphincterplasty for obstructive sleep apnea

Uvulopalatopharyngoplasty (UPPP) has been the most commonly performed procedure for obstructive sleep apnea. However, high failure rates of this procedure, which can reach 50%-70% of the cases, have led to various modifications in the UPPP technique to address persistent obstruction after traditional UPPP surgery. Expansion sphincteroplasty was developed as a modification of UPPP to address lateral wall collapse proximal to the free margin of the palate and transpalatal advancement pharyngoplasty was developed as a modification of UPPP to address more proximal anterior posterior narrowing of the retropalatal segment. Transpalatal advancement has also been shown to address proximal lateral wall airway narrowing.