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Erschienen in: Indian Journal of Otolaryngology and Head & Neck Surgery 2/2019

02.01.2019 | Original Article

Postoperative Pain and Wound Healing After Coblation-Assisted Barbed Anterior Pharyngoplasty (CABAPh): An Observational Study

verfasst von: Vittorio Rinaldi, Andrea Costantino, Antonio Moffa, Michele Cassano, Mario Mantovani, Manuele Casale, Lorenzo Pignataro

Erschienen in: Indian Journal of Otolaryngology and Head & Neck Surgery | Sonderheft 2/2019

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Abstract

Despite the numerous progresses in the palatal surgery, one of the critical aspect of snoring and OSA surgery is the postoperative pain. Over the last decades several surgical palatal procedures have been proposed. Our aim was to evaluate the tolerability of the coblation-assisted barbed anterior pharyngoplasty (CABAPh) in terms of postoperative pain and wound healing, compared with bipolar assisted barbed anterior pharyngoplasty (BAPh). An observational study on 20 patients with simple snoring was conducted. The outcomes measured to assessing pain were a 10 cm visual analog scale (VAS) and the dose of paracetamol + codeine administrated postoperatively. The wound healing was evaluated using a 3-point scale. The other parameters indicative of both pain and surgical repair were food intake and weight loss postoperatively. The mean overall pain (VAS scale) was significantly less in the CABAPh group (M 3.7; CI 3.34–4.06) compared with the BAPh (M 4.73; CI 4.28–5.19) with a P = 0.003. The mean wound healing after 4 weeks was significantly less in CABAPh group (M 2.7; CI 3.12–2.28) compared with the BAPh (M 2.1; CI 2.45–1.75) with a P = 0.02. There were no statistically significant difference with regard to food intake (P = 0.09) and weight loss (P = 0.94). The CABAPh was able to achieve a greater pain reduction and a faster wound healing compared with bipolar forceps.
Literatur
1.
Zurück zum Zitat Casale M, Pappacena M, Rinaldi V, Bressi F, Baptista P, Salvinelli F (2009) Obstructive sleep apnea syndrome: from phenotype to genetic basis. Curr Genomics 10(2):119–126CrossRef Casale M, Pappacena M, Rinaldi V, Bressi F, Baptista P, Salvinelli F (2009) Obstructive sleep apnea syndrome: from phenotype to genetic basis. Curr Genomics 10(2):119–126CrossRef
2.
Zurück zum Zitat Mantovani M, Minetti A, Torretta S, Pincherle A, Tassone G, Pignataro L (2012) The velo-uvulo-pharyngeal lift or “roman blinds” technique for treatment of snoring: a preliminary report. Acta Otorhinolaryngol Ital 32(1):48–53PubMedPubMedCentral Mantovani M, Minetti A, Torretta S, Pincherle A, Tassone G, Pignataro L (2012) The velo-uvulo-pharyngeal lift or “roman blinds” technique for treatment of snoring: a preliminary report. Acta Otorhinolaryngol Ital 32(1):48–53PubMedPubMedCentral
3.
Zurück zum Zitat Vicini C, De Vito A, Benazzo M et al (2012) The nose oropharynx hypopharynx and larynx (NOHL) classification: a new system of diagnostic standardized examination for OSAHS patients. Eur Arch Otorhinolaryngol 269(4):1297–1300CrossRef Vicini C, De Vito A, Benazzo M et al (2012) The nose oropharynx hypopharynx and larynx (NOHL) classification: a new system of diagnostic standardized examination for OSAHS patients. Eur Arch Otorhinolaryngol 269(4):1297–1300CrossRef
4.
Zurück zum Zitat Kezirian EJ, Hohenhorst W, de Vries N (2011) Drug-induced sleep endoscopy: the VOTE classification. Eur Arch Otorhinolaryngol 268(8):1233–1236CrossRef Kezirian EJ, Hohenhorst W, de Vries N (2011) Drug-induced sleep endoscopy: the VOTE classification. Eur Arch Otorhinolaryngol 268(8):1233–1236CrossRef
5.
Zurück zum Zitat Fujita S, Conway W, Zorick F, Roth T (1981) Surgical correction of anatomic azbnormalities in obstructive sleep apnea syndrome: uvulopalatopharyngoplasty. Otolaryngol Head Neck Surg 89(6):923–934CrossRef Fujita S, Conway W, Zorick F, Roth T (1981) Surgical correction of anatomic azbnormalities in obstructive sleep apnea syndrome: uvulopalatopharyngoplasty. Otolaryngol Head Neck Surg 89(6):923–934CrossRef
6.
Zurück zum Zitat Woodson BT, Robinson S, Lim HJ (2005) Transpalatal advancement pharyngoplasty outcomes compared with uvulopalatopharygoplasty. Otolaryngol Head Neck Surg 133(2):211–217CrossRef Woodson BT, Robinson S, Lim HJ (2005) Transpalatal advancement pharyngoplasty outcomes compared with uvulopalatopharygoplasty. Otolaryngol Head Neck Surg 133(2):211–217CrossRef
7.
Zurück zum Zitat Ellis PD (1994) Laser palatoplasty for snoring due to palatal flutter: a further report. Clin Otolaryngol Allied Sci 19(4):350–351CrossRef Ellis PD (1994) Laser palatoplasty for snoring due to palatal flutter: a further report. Clin Otolaryngol Allied Sci 19(4):350–351CrossRef
8.
Zurück zum Zitat Mair EA, Day RH (2000) Cautery-assisted palatal stiffening operation. Otolaryngol Head Neck Surg 122(4):547–556PubMed Mair EA, Day RH (2000) Cautery-assisted palatal stiffening operation. Otolaryngol Head Neck Surg 122(4):547–556PubMed
9.
Zurück zum Zitat Wassmuth Z, Mair E, Loube D, Leonard D (2000) Cautery-assisted palatal stiffening operation for the treatment of obstructive sleep apnea syndrome. Otolaryngol Head Neck Surg 123(1 Pt 1):55–60CrossRef Wassmuth Z, Mair E, Loube D, Leonard D (2000) Cautery-assisted palatal stiffening operation for the treatment of obstructive sleep apnea syndrome. Otolaryngol Head Neck Surg 123(1 Pt 1):55–60CrossRef
10.
Zurück zum Zitat Pang KP, Terris DJ (2007) Modified cautery-assisted palatal stiffening operation: new method for treating snoring and mild obstructive sleep apnea. Otolaryngol Head Neck Surg 136(5):823–826CrossRef Pang KP, Terris DJ (2007) Modified cautery-assisted palatal stiffening operation: new method for treating snoring and mild obstructive sleep apnea. Otolaryngol Head Neck Surg 136(5):823–826CrossRef
11.
Zurück zum Zitat Binar M, Karakoc O (2018) Anterior palatoplasty for obstructive sleep apnea: a systematic review and meta-analysis. Otolaryngol Head Neck Surg 158(3):443–449CrossRef Binar M, Karakoc O (2018) Anterior palatoplasty for obstructive sleep apnea: a systematic review and meta-analysis. Otolaryngol Head Neck Surg 158(3):443–449CrossRef
12.
Zurück zum Zitat Pang KP, Pang EB, Pang KA, Rotenberg B (2018) Anterior palatoplasty in the treatment of obstructive sleep apnoea - a systemic review. Acta Otorhinolaryngol Ital 38(1):1–6PubMed Pang KP, Pang EB, Pang KA, Rotenberg B (2018) Anterior palatoplasty in the treatment of obstructive sleep apnoea - a systemic review. Acta Otorhinolaryngol Ital 38(1):1–6PubMed
13.
Zurück zum Zitat Marzetti A, Tedaldi M, Passali FM (2013) Preliminary findings from our experience in anterior palatoplasty for the treatment of obstructive sleep apnea. Clin Exp Otorhinolaryngol 6(1):18–22CrossRef Marzetti A, Tedaldi M, Passali FM (2013) Preliminary findings from our experience in anterior palatoplasty for the treatment of obstructive sleep apnea. Clin Exp Otorhinolaryngol 6(1):18–22CrossRef
14.
Zurück zum Zitat Mantovani M, Minetti A, Torretta S, Pincherle A, Tassone G, Pignataro L (2013) The, “Barbed Roman Blinds” technique: a step forward. Acta Otorhinolaryngol Ital 33(2):128PubMedPubMedCentral Mantovani M, Minetti A, Torretta S, Pincherle A, Tassone G, Pignataro L (2013) The, “Barbed Roman Blinds” technique: a step forward. Acta Otorhinolaryngol Ital 33(2):128PubMedPubMedCentral
15.
Zurück zum Zitat Mantovani M, Rinaldi V, Torretta S, Carioli D, Salamanca F, Pignataro L (2016) Barbed Roman blinds technique for the treatment of obstructive sleep apnea: how we do it? Eur Arch Otorhinolaryngol 273(2):517–523CrossRef Mantovani M, Rinaldi V, Torretta S, Carioli D, Salamanca F, Pignataro L (2016) Barbed Roman blinds technique for the treatment of obstructive sleep apnea: how we do it? Eur Arch Otorhinolaryngol 273(2):517–523CrossRef
16.
Zurück zum Zitat Mantovani M, Carioli D, Torretta S, Rinaldi V, Ibba T, Pignataro L (2017) Barbed snore surgery for concentric collapse at the velum: the Alianza technique. J Craniomaxillofac Surg 45(11):1794–1800CrossRef Mantovani M, Carioli D, Torretta S, Rinaldi V, Ibba T, Pignataro L (2017) Barbed snore surgery for concentric collapse at the velum: the Alianza technique. J Craniomaxillofac Surg 45(11):1794–1800CrossRef
17.
Zurück zum Zitat Belloso A, Morar P, Tahery J, Saravanan K, Nigam A, Timms MS (2006) Randomized-controlled study comparing post-operative pain between coblation palatoplasty and laser palatoplasty. Clin Otolaryngol 31(2):138–143CrossRef Belloso A, Morar P, Tahery J, Saravanan K, Nigam A, Timms MS (2006) Randomized-controlled study comparing post-operative pain between coblation palatoplasty and laser palatoplasty. Clin Otolaryngol 31(2):138–143CrossRef
18.
Zurück zum Zitat Salamanca F, Costantini F, Mantovani M et al (2014) Barbed anterior pharyngoplasty: an evolution of anterior palatoplasty. Acta Otorhinolaryngol Ital 34(6):434–438PubMedPubMedCentral Salamanca F, Costantini F, Mantovani M et al (2014) Barbed anterior pharyngoplasty: an evolution of anterior palatoplasty. Acta Otorhinolaryngol Ital 34(6):434–438PubMedPubMedCentral
19.
Zurück zum Zitat Mantovani M, Rinaldi V, Salamanca F et al (2015) Should we stop performing uvulopalatopharyngoplasty? Indian J Otolaryngol Head Neck Surg 67(Suppl 1):161–162CrossRef Mantovani M, Rinaldi V, Salamanca F et al (2015) Should we stop performing uvulopalatopharyngoplasty? Indian J Otolaryngol Head Neck Surg 67(Suppl 1):161–162CrossRef
20.
Zurück zum Zitat Walker RP, Grigg-Damberger MM, Gopalsami C (1997) Uvulopalatopharyngoplasty versus laser-assisted uvulopalatoplasty for the treatment of obstructive sleep apnea. Laryngoscope 107(1):76–82CrossRef Walker RP, Grigg-Damberger MM, Gopalsami C (1997) Uvulopalatopharyngoplasty versus laser-assisted uvulopalatoplasty for the treatment of obstructive sleep apnea. Laryngoscope 107(1):76–82CrossRef
21.
Zurück zum Zitat Osman EZ, Osborne JE, Hill PD, Lee BW, Hammad Z (2000) Uvulopalatopharyngoplasty versus laser assisted uvulopalatoplasty for the treatment of snoring: an objective randomised clinical trial. Clin Otolaryngol Allied Sci 25(4):305–310CrossRef Osman EZ, Osborne JE, Hill PD, Lee BW, Hammad Z (2000) Uvulopalatopharyngoplasty versus laser assisted uvulopalatoplasty for the treatment of snoring: an objective randomised clinical trial. Clin Otolaryngol Allied Sci 25(4):305–310CrossRef
22.
Zurück zum Zitat Ugur KS, Kurtaran H, Ark N, Kizilbulut G, Yuksel A, Gunduz M (2013) Comparing anterior palatoplasty and modified uvulopalatopharyngoplasty for primary snoring patients: preliminary results. B-ENT 9(4):285–291PubMed Ugur KS, Kurtaran H, Ark N, Kizilbulut G, Yuksel A, Gunduz M (2013) Comparing anterior palatoplasty and modified uvulopalatopharyngoplasty for primary snoring patients: preliminary results. B-ENT 9(4):285–291PubMed
23.
Zurück zum Zitat Pynnonen M, Brinkmeier JV, Thorne MC, Chong LY, Burton MJ (2017) Coblation versus other surgical techniques for tonsillectomy. Cochrane Database Syst Rev 8:CD004619PubMed Pynnonen M, Brinkmeier JV, Thorne MC, Chong LY, Burton MJ (2017) Coblation versus other surgical techniques for tonsillectomy. Cochrane Database Syst Rev 8:CD004619PubMed
24.
Zurück zum Zitat Wiltshire D, Cronin M, Lintern N et al (2018) The debate continues: a prospective, randomised, single-blind study comparing Coblation and bipolar tonsillectomy techniques. J Laryngol Otol 132(3):240–245CrossRef Wiltshire D, Cronin M, Lintern N et al (2018) The debate continues: a prospective, randomised, single-blind study comparing Coblation and bipolar tonsillectomy techniques. J Laryngol Otol 132(3):240–245CrossRef
25.
Zurück zum Zitat Mitic S, Tvinnereim M, Lie E, Saltyte BJ (2007) A pilot randomized controlled trial of coblation tonsillectomy versus dissection tonsillectomy with bipolar diathermy haemostasis. Clin Otolaryngol 32(4):261–267CrossRef Mitic S, Tvinnereim M, Lie E, Saltyte BJ (2007) A pilot randomized controlled trial of coblation tonsillectomy versus dissection tonsillectomy with bipolar diathermy haemostasis. Clin Otolaryngol 32(4):261–267CrossRef
26.
Zurück zum Zitat Glade RS, Pearson SE, Zalzal GH, Choi SS (2006) Coblation adenotonsillectomy: an improvement over electrocautery technique? Otolaryngol Head Neck Surg 134(5):852–855CrossRef Glade RS, Pearson SE, Zalzal GH, Choi SS (2006) Coblation adenotonsillectomy: an improvement over electrocautery technique? Otolaryngol Head Neck Surg 134(5):852–855CrossRef
Metadaten
Titel
Postoperative Pain and Wound Healing After Coblation-Assisted Barbed Anterior Pharyngoplasty (CABAPh): An Observational Study
verfasst von
Vittorio Rinaldi
Andrea Costantino
Antonio Moffa
Michele Cassano
Mario Mantovani
Manuele Casale
Lorenzo Pignataro
Publikationsdatum
02.01.2019
Verlag
Springer India
Erschienen in
Indian Journal of Otolaryngology and Head & Neck Surgery / Ausgabe Sonderheft 2/2019
Print ISSN: 2231-3796
Elektronische ISSN: 0973-7707
DOI
https://doi.org/10.1007/s12070-018-01577-8

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