Edema and Subjective Discomfort After Barbed Stayed Bridge Pharyngoplasty (BSBP)

<b>Background</b>: Obstructive Sleep Apnea (OSA) is commonly treated with CPAP, though low patient compliance often limits its long-term use. Surgical alternatives, such as Barbed Pharyngoplasty, have been developed to address retro-velar collapse. A recent technique, Barbed Stayed Bridge Pharyngoplasty (BSBP), aims to preserve oropharyngeal anatomy while enhancing airway stability. This study evaluates the immediate postoperative outcomes and patient discomfort following BSBP for OSA. <b>Material and Method</b>: Thirty patients (mean age 40.7 ± 8.9 years; BMI 25.9 ± 1.7) underwent BSBP at Sapienza University of Rome between January 2022 and January 2024. Inclusion criteria included AHI 15-30, BMI ≤ 35, and specific DISE findings. Postoperative outcomes were evaluated using polysomnographic data (AHI, ODI), the Epworth Sleepiness Scale (ESS), pain scores (VAS), edema grading (Ezzat score), and the PPOPS questionnaire. Follow-ups were performed at 12, 24, and 48 h; 1 month; and 6 months postoperatively. <b>Results</b>: Thirty patients (average age 40.7) with mild to moderate OSA underwent surgery. After six months, there was a significant reduction in AHI (from 23.4 ± 2.1 to 7.2 ± 2.6) and ODI (from 21.0 ± 4.1 to 6.5 ± 2.1), along with a statistically significant improvement in the Epworth Sleepiness Scale. Postoperative pain (VAS) decreased from 3.0 ± 1.5 at 12 h to 0.2 ± 0.5 at one month, and edema (Ezzat score) decreased from 2.0 ± 0.6 at 12 h to 0.0 ± 0.0 at one month, both with significant differences. The PPOPS questionnaire scores remained relatively stable, with mean values of 4.9 ± 2.3 at 12 h, 2.7 ± 1.6 at 24 h, 1.2 ± 1.1 at 48 h, and 0.5 ± 0.7 at one month, showing statistically significant change (<i>p</i> < 0.005). No postoperative bleeding occurred. According to Sher's criteria, the procedure was consistently effective. <b>Conclusions</b>: BSBP significantly reduces AHI and ODI, demonstrating effective symptom resolution with minimal discomfort and rapid recovery. These results suggest that BSBP may be a viable, less invasive surgical technique for OSA surgeries.