HSC Section 3 - Trauma, Critical Care and Sleep Medicine

Yaremchuk

Fig. 6. ( A ) Tonsillectomy is performed. ( B ) Horizontal incision made to divide the inferior end of the palatopharyngeus muscle. ( C ) The palatopharyngeus muscle is mobilized, although not completely, with care taken to leave its fascia attachments to the deeper horizontal constrictor muscles. ( D ) Superolateral incision made on the soft palate, revealing the arching fibers of the palatine muscles. ( E ) Sutures are used to hitch up ( ar- rows ) the palatopharyngeus muscle to the soft palate muscles superolaterally. ( F ) Closure of the palatal incisions. ( From Pang K, Woodson BT. Expansion sphincter pharyngoplasty: a new technique for the treatment of obstructive sleep apnea. Otolaryngol Head Neck Surg 2007;137:111–2; with permission.)

Z-PALATOPLASTY

Friedman and colleagues 21 described a modification of uvulopalatopharyngoplasty based on a bilateral z-plasty in treating patients without tonsils and an unfavorable tongue position (Friedman tongue position [FTP] III and IV). 21 Patients who have had tonsillectomy often have posterior displacement of the palate. This displacement is

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