ZPPP Combined with Endoscopic Coblator Open Tongue Base Resection for Severe OSAHS

Abstract

Objectives: Retrospectively investigate the safety and outcomes of Z-palatopharyngoplasty (ZPPP) combined with endoscopic coblator open tongue base resection (ECO-TBR) for the treatment of severe obstructive sleep apnea/hypopnea syndrome (OSAHS). Methods: Thirty-five consecutive patients with severe OSAHS who had multilevel obstruction, failed continuous positive airway pressure therapy, and then underwent ZPPP combined with ECO-TBR were enrolled in this study. The subjective symptoms and objective PSG parameters were collected preoperatively and at a minimum of 3 months postoperatively. Statistical analysis was determined by Wilcoxon signed rank test. Results: Three female and 32 male patients (mean, 42 years) had a minimum follow-up of 3 months and complete data available for analysis. None of the patients had perioperative or postoperative complications. No long-term obvious velopharyngeal insufficiency was encountered. The classical success rate was 62.9% (22/35). Three months postoperatively, the Epworth sleepiness scale decreased from 11.0 ± 4.2 to 8.7 ± 4.3 (p = 0.0006). The apnea/hypopnea index (/hr.), lowest oxygen saturation (%), and bed partner evaluation of patient’s snoring visual analog scale (0-10) decreased from 50.6±16.6 to 26.5 ± 23.5, 70.4 ± 9.9 to 80.1 ± 11.3, 9.86 ± 0.69 to 3.27 ± 1.96, respectively (all p<0.0001). Conclusions: This study shows the significant benefits of ZPPP plus ECO-TBR in severe OSAHS patients.