Expansion sphincter pharyngoplasty and palatal advancement pharyngoplasty: airway evaluation and surgical techniques

Multiple palatopharyngoplasty techniques are available for reconstruction of the upper pharyngeal airway. To select appropriate procedures, the surgeon requires classification methods, but traditional staging systems only describe levels of obstruction and do not relate sufficient anatomical detail to specify an intervention. A method of awake, upper airway evaluation is described, which allows the surgeon to direct specific surgical procedures to particular luminal shapes and anatomical structures. Expansion sphincter pharyngoplasty is a procedure for treatment of lateral pharyngeal stenosis, where rotation of the palatopharyngeus muscle is performed to widen the pharynx and advance the soft palate anteriorly. Palatal advancement pharyngoplasty is a technique for treatment of posterior retro-palatal obstruction which results in anterior palatal advancement. Surgical techniques and management are described.