ePoster
Presentations Description
Institution: Westmead Hospital - New South Wales, Australia
Background:
Traditional uvulopalatopharyngoplasty (UPPP) for obstructive sleep apnoea (OSA) achieves airway patency by excising soft-palate and uvular tissue but often impairs velopharyngeal function. Complications such as velopharyngeal insufficiency, dysphonia, and globus sensation are frequent after aggressive resection. Modern sleep surgery now favours anatomical preservation and dynamic reconstruction. The Corner Suspension UPPP was developed to address these issues through targeted suspension, tension redistribution, and scaffolded healing—achieving durable retropalatal expansion without tissue sacrifice.
Methods:
Following tonsillectomy and limited tip uvulectomy (preserving the uvular bulb), bilateral corner suspension is performed using a curved 36 mm J-shaped 0-Vicryl (ASH-35) needle. The suture passes through the anterior and posterior tonsillar pillars at the level of the upper third molar, engaging the tonsillar fossa and then traversing behind the soft palate. It is anchored into the periosteum and gingival mucosa near the maxillary tuberosity, generating a vector that elevates, lateralises, and anteriorly repositions the soft palate. The Boyle-Davis gag is released one notch to achieve physiologic tension before knot tying, producing a squared, taut retropalatal space. Suspension sutures are removed on day 5, facilitating scaffolded healing and long-term palatal remodelling.
Results:
The procedure was completed uneventfully in all cases, with no bleeding or airway compromise. Early results show stable palatal repositioning, preserved speech and swallowing, and encouraging symptomatic and polysomnographic improvement.
Conclusion:
The Corner Suspension UPPP is a precise, reproducible, and anatomy-preserving evolution in palatal surgery. By replacing resection with suspension, it achieves durable airway enlargement while maintaining normal palatal physiology—a function-preserving alternative to conventional UPPP.
Speakers
Authors
Authors
Dr Praween Senanayake - , A/Prof Narinder Singh -
