{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:21:49Z","timestamp":1760059309002,"version":"build-2065373602"},"reference-count":11,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T00:00:00Z","timestamp":1748822400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Collapse of the lateral pharyngeal wall (LPW) in the pathogenesis of OSA appears to be the only independent risk factor for OSA. Therefore, since 2003, when Cahali first published the technique of lateral pharyngoplasty, several surgical techniques targeting the LPW have been described. Central to these is the concept of widening and stabilizing the pharyngeal airspace by treating the collapse of the LPW rather than removing the redundant pharyngeal soft tissue. The advent of robotic surgery has led to the development of new techniques in OSA surgery, the main target of which is the base of the tongue. Pharyngoplasty using robotic technology can be beneficial when this procedure is combined with tongue base reduction, which is known to be best performed with robotic surgery. Methods: This article presents a new technique for functional expansion pharyngoplasty (FEP), which is a modification of the functional expansion pharyngoplasty previously described by Sorrenti and Piccin and is performed using robotic surgery with a Da Vinci system. Results and Conclusions: Transoral robotic functional expansion pharyngoplasty is an effective, standardizable technique for treating OSA, notable for its ease of learning and performing.<\/jats:p>","DOI":"10.3390\/jcm14113904","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T10:21:49Z","timestamp":1748859709000},"page":"3904","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trans Oral Robotic Functional Expansion Pharyngoplasty (TORFEP) with Unidirectional Barbed Sutures"],"prefix":"10.3390","volume":"14","author":[{"given":"Riccardo","family":"Nocini","sequence":"first","affiliation":[{"name":"Unit of Otolaryngology\u2014Head and Neck Department, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1038\/s41392-023-01496-3","article-title":"Pathophysiological mechanisms and therapeutic approaches in obstructive sleep apnea syndrome","volume":"8","author":"Lv","year":"2023","journal-title":"Signal Transduct. Target. Ther."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1007\/s11325-021-02412-1","article-title":"Obstructive sleep apnea syndrome in non-obese patients","volume":"26","author":"Antonaglia","year":"2022","journal-title":"Sleep. Breath."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Gulotta, G., Iannella, G., Vicini, C., Polimeni, A., Greco, A., de Vincentiis, M., Visconti, I.C., Meccariello, G., Cammaroto, G., and De Vito, A. (2019). Risk Factors for Obstructive Sleep Apnea Syndrome in Children: State of the Art. Int. J. Environ. Res. Public. Health, 16.","DOI":"10.3390\/ijerph16183235"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1164\/ajrccm.154.4.8887615","article-title":"Upper airway and soft tissue structural changes induced by CPAP in normal subjects","volume":"154","author":"Schwab","year":"1996","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"103344","DOI":"10.1016\/j.amjoto.2021.103344","article-title":"Predictors of response to sleep apnea surgery addressing the lateral pharyngeal wall collapse","volume":"43","author":"Piccin","year":"2022","journal-title":"Am. J. Otolaryngol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2165","DOI":"10.1007\/s11325-023-02808-1","article-title":"Sleep parameter characteristics of patients with OSA who have retropalatal circumferential narrowing and the clinical significance of lateral pharyngeal wall collapse during sleep","volume":"27","author":"AHan","year":"2023","journal-title":"Sleep. Breath."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.1097\/00005537-200311000-00020","article-title":"Lateral pharyngoplasty: A new treatment for obstructive sleep apnea hypopnea syndrome","volume":"113","author":"Cahali","year":"2003","journal-title":"Laryngoscope"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Cammaroto, G., Stringa, L.M., Zhang, H., Capaccio, P., Galletti, F., Galletti, B., Meccariello, G., Iannella, G., Pelucchi, S., and Baghat, A. (2020). Alternative Applications of Trans-Oral Robotic Surgery (TORS): A Systematic Review. J. Clin. Med., 9.","DOI":"10.3390\/jcm9010201"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2905","DOI":"10.1002\/lary.23911","article-title":"Functional expansion pharyngoplasty in the treatment of obstructive sleep apnea","volume":"123","author":"Sorrenti","year":"2013","journal-title":"Laryngoscope"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1111\/coa.13105","article-title":"Functional expansion pharyngoplasty: Technical update by unidirectional barbed sutures","volume":"43","author":"Sorrenti","year":"2018","journal-title":"Clin. Otolaryngol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1793","DOI":"10.1007\/s00405-020-05883-2","article-title":"Lateral pharyngoplasty techniques for obstructive sleep apnea syndrome: A comparative experimental stress test of two different techniques","volume":"277","author":"Iannella","year":"2020","journal-title":"Eur. Arch. Otorhinolaryngol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/11\/3904\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:46:06Z","timestamp":1760031966000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/11\/3904"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,2]]},"references-count":11,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["jcm14113904"],"URL":"https:\/\/doi.org\/10.3390\/jcm14113904","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2025,6,2]]}}}