Which surgical procedure is more effective for obstructive sleep apnea-CWICKs or barbed reposition pharyngoplasty (BRP)?

OBJECTIVE

Uvulopalatopharyngoplasty has long been a standard surgical treatment for obstructive sleep apnea (OSA). Recently, novel suture techniques such as CWICKs and barbed reposition pharyngoplasty (BRP) have been developed. This study aimed to compare the surgical efficacy of CWICKs and BRP.

METHODS

A retrospective case-control study was conducted involving 21 patients (18 males and 3 females) with OSA who underwent either CWICKs (n = 9) or BRP (n = 12) between April 2020 and January 2025. Outcomes were evaluated using home sleep apnea testing before surgery and two months postoperatively.

RESULTS

Both CWICKs and BRP significantly improved the respiratory event index (REI), obstructive apnea index (OAI), and lowest SpO2. No significant differences were observed between the two groups in the improvement rates of REI, OAI, hypopnea index (HI)/REI ratio, lowest SpO2, Epworth Sleepiness Scale, or surgical success. However, only CWICKs significantly improved the HI/REI ratio, suggesting that CWICKs shifted apnea events to hypopnea. The operative time was significantly longer in the CWICKs group compared with the BRP group.

CONCLUSION

In this retrospective, non-contemporaneous comparison of CWICKs and BRP for obstructive sleep apnea, both procedures demonstrated significant short-term improvements in HSAT parameters, including REI, OAI, and lowest oxygen saturation at two months postoperatively. No significant between-group differences were observed in overall respiratory event indices, although operative time was longer for CWICKs. Our results suggest that CWICKs and BRP may provide comparable short-term outcomes in selected patients.