About Pang’s Expansion Pharyngoplasty
In Obstructive Sleep Apnea, collapse of the upper airway is usually multi-level: at the level of the nose, velopharynx (palate), base of tongue, and/or the lateral (side) pharyngeal walls.
Many patients with OSA have bulky lateral (side) pharyngeal walls that vibrate and contribute to the collapse of the upper airway. In imaging studies, lateral (side) pharyngeal muscle wall collapse has been demonstrated to be important in the pathogenesis of OSA.
Up to 2007, most would concur that it is difficult to surgically create adequate lateral pharyngeal wall tension to prevent its collapse. The traditional sleep apnea surgery would be the UvuloPalatoPharyngoplasty (UPPP), a procedure focussed primarily on cutting away soft tissue or the palate.
In 2007, Dr Kenny Pang invented the Expansion Sphincter Pharyngoplasty, a palate-positioning technique that successfully created the necessary tension in the lateral pharyngeal walls to prevent collapse and reduce the number of apneic episodes.
In the clinical trial to follow, by Dr Pang and Tucker Woodson (Medical College Wisconsin, USA), the Pang and Woodson (2007) results for the two patient groups, The Pang’s Expansion Group, and The UvuloPalatoPharyngoplasty (UPPP) Group yielded success rates of 82.6% in the Pang’s Expansion Group compared to 68.1% in the traditional UPPP group (p<0.05).
It is significant, that the Pang’s Expansion Pharyngoplasty was superior in terms of treatment results.
The procedure marked a significant milestone in sleep medicine, shifting the international paradigm of sleep surgery from destructive tissue removal to reconstructive muscle repositioning.
Since then, the Pang’s Expansion Sphincter Pharyngoplasty is taught in medical sleep surgery courses globally where Dr Pang has taught over 1000 ENT surgeons in the past 2 decades.
Notably, extensive international meta-analyses spanning over 17 years have shown that the technique maintains an 80%+ long-term success rate in the reduction of sleep apnea episodes and achieving beneficial patient treatment outcomes.
