Conclusion: 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). Objective: To study the safety and efficacy of ZPPP combined with RFBOT for the treatment of moderate/severe OSAHS. Methods: 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. Results: 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).
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