Lin Hsin-Ching, Friedman Michael, Chang Hsueh-Wen, Su Mao-Chang, Wilson Meghan
Department of Otolaryngology, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Acta Otolaryngol. 2010 Sep;130(9):1070-6. doi: 10.3109/00016481003606240.
Z-palatopharyngoplasty (ZPPP) combined with radiofrequency to the base of tongue (RFBOT) resulted in short-term morbidity only. This study shows the clinical benefits of ZPPP plus RFBOT in patients with moderate/severe obstructive sleep apnea/hypopnea syndrome (OSAHS).
To study the safety and efficacy of ZPPP combined with RFBOT for the treatment of moderate/severe OSAHS.
Charts of all patients with moderate/severe OSAHS who failed or refused CPAP therapy and underwent surgical treatment of ZPPP plus RFBOT were reviewed. The subjective symptoms and objective polysomnographic parameters were collected preoperatively and postoperatively. Postoperative morbidity was recorded.
Forty-three OSAHS patients (2 females, 41 males, mean age 39 years) had full data and a minimum 6 month follow-up to assess efficacy. Intraoperative, short-term, and long-term morbidities are reported. No long-term velopharyngeal insufficiency was encountered. The classical success rate was 60.5% (26/43). Six months after the treatment, the mean Epworth sleepiness scale changed from 12.8 +/- 5.1 to 10.0 +/- 4.3 (p = 0.002). The apnea/hypopnea index (/h), lowest oxygen saturation (%), and bed partner assessed snoring visual analog scale (0-10) changed from 51.5 +/- 25.4 to 23.4 +/- 24.7, 75.5 +/- 10.4 to 82.1 +/- 10.9, and 8.4 +/- 1.6 to 2.9 +/- 1.6, respectively (all p < 0.0001, paired t test).
Z形腭咽成形术（ZPPP）联合舌根射频消融术（RFBOT）仅导致短期并发症。本研究显示了ZPPP加RFBOT治疗中度/重度阻塞性睡眠呼吸暂停/低通气综合征（OSAHS）的临床益处。
研究ZPPP联合RFBOT治疗中度/重度OSAHS的安全性和有效性。
回顾了所有中度/重度OSAHS患者的病历，这些患者CPAP治疗失败或拒绝接受CPAP治疗，并接受了ZPPP加RFBOT手术治疗。收集术前和术后的主观症状和客观多导睡眠图参数。记录术后并发症。
43例OSAHS患者（2例女性，41例男性，平均年龄39岁）有完整数据且至少随访6个月以评估疗效。报告了术中、短期和长期并发症。未发现长期腭咽闭合不全。经典成功率为60.5%（26/43）。治疗6个月后，平均爱泼沃斯嗜睡量表评分从12.8±5.1降至10.0±4.3（p = 0.002）。呼吸暂停/低通气指数（次/小时）、最低血氧饱和度（%）和床伴评估的打鼾视觉模拟量表（0-10）分别从51.5±25.4降至23.4±24.7、75.5±10.4升至82.1±10.9、8.4±1.6降至2.9±1.6（所有p < 0.0001，配对t检验）。
