Arman Afrashi
Buca Seyfi Demirsoy State Hospital, Turkey.
Title: Pharyngolateral ferromagnetic prosthesis (PFP) for treatment of obstructive sleep apnea
Biography
Biography: Arman Afrashi
Abstract
Obstructive sleep apnea is a disease consisting of episodes of partial or complete closure of the upper airway that occur during sleep and lead to breathing cessation defined as a period of apnea more than 10 s. Symptom include restlessness, snoring, recurrent awakening, morning head- ache and excessive day time sleepiness. Diagnosis of obstructive sleep apnea is based on sleep history and pol- ysomnography. Today the major treatment methods are continuous positive airway pressure, weight loss, positional therapy, oral appliances and different surgical procedures such as tracheostomy, nasal surgery, radiofre- quency of palatal region, soft palate implants, uvulophar- yngopalatoplasty, tongue base surgery, hyoid suspension, lateral pharyngoplasty, genioglossal advancement and maxillomandibular advancement.
In all of these surgical procedures except maxilloman- dibular advancement, the main problem is failure of pre- venting the collapse of lateral pharyngeal wall. In this new technique pharyngolateral ferromagnetic prosthesis will prevent the collapse of lateral pharyngeal wall during sleep.
Pharyngolateral ferromagnetic prosthesis: it contains two parts for each side of the pharyngeal part of the neck.
1. Internal part of prosthesis: it contains a fragmented thin part of a ferromagnetic material such as Iron (Fe), coated with biocompatible Silicone or another bio- compatible material.
2. External part of prosthesis: it contains a natural magnet with power between 6,000 and 10,000 Gauss. The external part of pharyngolateral ferromagnetic pros- thesis will use only during sleep in external part of the neck .
Surgical technique: patient will be in supine position and under general anesthesia during surgery. After inserting Davis-Boyle mouth gag, surgeon should make a 3-cm-long incision vertically in lateral wall of pharynx at the level of base of the tongue. Then surgeon should make dissection under mucosal and submucosal layers toward hypophar- ynx. After that he/she should insert the internal part of prosthesis and at the end close the incision . Then surgeon could perform the same procedure to the opposite side of the neck or perform unilaterally.
A few days after surgery patient should use the external part of the prosthesis in both sides of the neck during sleep. The magnetic power of external part of pros- thesis will pull the internal part of prosthesis and lateral hypopharyngeal wall together and this will prevent the collapse of lateral pharyngeal wall and obstructive attacks.