CPAP vs Expansion Sphincter Pharyngoplasty for Treating Obstructive Sleep Apnea

Is expansion sphincter pharyngoplasty for OSA a viable alternative to CPAP? Investigators compared outcomes of the 2 treatment modalities.

Among individuals with obstructive sleep apnea (OSA) who demonstrate signs of lateral pharyngeal collapse, the use of expansion sphincter pharyngoplasty (ESP) is a viable alternative therapeutic option to continuous positive airway pressure (CPAP), according to findings presented at the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) 2022 Annual Meeting and OTO Experience, held in Philadelphia, Pennsylvania, September 10 to 14, 2022.

Although CPAP remains the mainstay of medical treatment for patients with OSA, patient adherence is frequently suboptimal. Researchers therefore conducted a retrospective study to compare treatment outcomes of patients undergoing ESP vs CPAP.

All patients who were diagnosed with OSA and underwent ESP or were prescribed CPAP between 2019 and 2021 at the researchers’ institution were evaluated for study inclusion. All patients in the ESP cohort (n=57) had undergone preoperative and postoperative sleep studies; all patients in the CPAP cohort (n=54) had been followed up at the investigators’ sleep clinic and had smartcard data available for analysis. Treatment outcomes were measured by calculating the mean disease alleviation. Charts were reviewed for sleep study results and demographic information.

The researchers found that the mean pretreatment apnea-hypopnea index (AHI) was similar between both of the treatment cohorts (P =.73). The overall reduction in AHI was significantly greater in the CPAP group than in the ESP group (P =.007). No statistically significant difference was observed in mean disease alleviation, however, between the 2 groups (49.9 in the CPAP group vs 48.0 in the ESP group; P =.97). Residual AHI was 17.4 in the CPAP group vs 17.5 in the ESP group (P =.97).

The researchers concluded that the findings from the current study demonstrate that, “ESP may serve as an effective treatment option for eligible patients who cannot tolerate CPAP.”


Fiorella M, Armache M, Jamil SB, Boon MS, Huntley CT. Treatment outcomes of expansion sphincter pharyngoplasty versus continuous positive airway pressure. Otolaryngol Head Neck Surg. 2022;167(1 suppl):P160.

This article originally appeared on Pulmonology Advisor