Is Hospital Admission Required Following Expansion Sphincter Pharyngoplasty?

Sunday, October 18, 2026

11:24 AM - 11:30 AM PT

Location: 403B

Presenting Author(s)

AM

Aniket Maini, BS

Medical Student
UMass Chan Medical School
Worcester, Massachusetts, United States

Co-Author(s)

Soomin Myoung, MD

Resident
Duke University Department of Otolaryngology
Durham, NC, United States

Senior Author(s)

CI

Christopher J. Ito, MD, MEd

Associate Professor; Director, Rhinology & Endoscopic Skull Base Surgery
UMass Memorial Medical Center / UMass Chan Medical School
Worcester, MA, United States

Disclosure(s):

Soomin Myoung, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Christopher J. Ito, MD, MEd:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Expansion sphincter pharyngoplasty is a surgical intervention for obstructive sleep apnea (OSA) and entails overnight hospitalization for postoperative monitoring; however, this may not be routinely necessary. This study evaluated immediate postoperative factors necessitating inpatient observation while also assessing ESP’s efficacy in OSA reduction.

Methods: A retrospective chart review of 29 patients who underwent ESP from 10/2017 to 4/2025 at a tertiary academic medical center was conducted. Postoperative hospital course evaluation included mode of ventilation, oxygen saturation, and pain management, all reviewed at 4-hour intervals. Preoperative and postoperative changes following ESP were assessed using sleep study and drug-induced sleep endoscopy (DISE) results. Repeated measures Friedman test was used for continuous variables, including oxygen saturation and pain scores. Cochran’s Q test was used for categorical repeated measurements, including ventilation mode. A Wilcoxon rank sum test was used to assess pre/postoperative impact of ESP, including changes in AHI and DISE results.

Results: ESP significantly reduced OSA severity, with mean AHI decreasing from 37.39 ± 22.01 to 17.24 ± 10.01 (p = 0.04). DISE findings demonstrated oropharyngeal obstruction improvement (1.7 ± 0.67 to 0.8 ± 0.92 (p = 0.03)). Postoperative oxygen saturation, pain levels, and analgesic requirements remained stable throughout hospitalization. Supplemental ventilation was required only in the immediate recovery period and was discontinued within four hours. The overall complication rate was low; 3 patients experienced delayed bleeding that required control in the operating room on average at postoperative day 4.

Conclusions: ESP is effective in reducing OSA severity with minimal early postoperative complications. These findings suggest that routine overnight hospitalization may not be necessary for all patients undergoing ESP, warranting reconsideration of current postoperative admission protocols.