American journal of otolaryngology · 2025
Modified uvulopalatopharyngoplasty: "8" suture abduction-suspension of the palatopharyngeal muscle.
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Xu Yingxiang, Zhu Shan, Li Jinlian, He Siyu, Yu Riqing, Hong Haiyu, He Peng
Аннотация
OBJECTIVE: To evaluate the efficacy of a modified uvulopalatopharyngoplastyof "8" suture abduction-suspension of the palatopharyngeal muscle (8-ASP) in the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS).
MATERIAL AND METHODS: Twenty-eight consecutive patients with OSAHS with AHI > 15 with tonsillar hypertrophy, Friedman stage ≤3 and palatal collapse or obstruction were included, and all patients underwent modified uvulopalatopharyngoplasty that consisted of bilateral tonsillectomy, dissection and removal of submucosal adipose tissue of the soft palate and supratonsillar area; partial incision (0.4-0.6 cm) of the dorsal mucosa and muscle; and 8-ASP to the pterygomandibular ligament. Variables of polysomnography included the apnoea-hypo pnoea index (AHI), minimum oxygen saturation (MSAT), Stage N3 sleep, and Epworth sleepiness scale (ESS) score was also used to evaluate surgical results. Surgical success was defined as a greater than 50 % reduction in pre-operative AHI and a post-operative AHI of less than 20 per hour.
RESULTS: Six months after operation, 24 patients (85.71 %) responded successfully. The mean apnoea-hypo pnoea index decreased from 51.72 ± 26.45 to 12.97 ± 8.49 (P < 0.001), and the mean MSAT, Stage N3 sleep and ESS score improved significantly (P < 0.001). The postoperative sequelae were mild with 3.57 % of occasional nasal regurgitation.
CONCLUSIONS: 8-ASP is a novel, simplified and effective surgical treatment for OSAHS patients with a high success rate (85.71 %) and minimal adverse effect in selected patients, and this technique suggests a role of abduction-suspension of the palatopharyngeal muscle in the palatal surgery for OSAHS.
MATERIAL AND METHODS: Twenty-eight consecutive patients with OSAHS with AHI > 15 with tonsillar hypertrophy, Friedman stage ≤3 and palatal collapse or obstruction were included, and all patients underwent modified uvulopalatopharyngoplasty that consisted of bilateral tonsillectomy, dissection and removal of submucosal adipose tissue of the soft palate and supratonsillar area; partial incision (0.4-0.6 cm) of the dorsal mucosa and muscle; and 8-ASP to the pterygomandibular ligament. Variables of polysomnography included the apnoea-hypo pnoea index (AHI), minimum oxygen saturation (MSAT), Stage N3 sleep, and Epworth sleepiness scale (ESS) score was also used to evaluate surgical results. Surgical success was defined as a greater than 50 % reduction in pre-operative AHI and a post-operative AHI of less than 20 per hour.
RESULTS: Six months after operation, 24 patients (85.71 %) responded successfully. The mean apnoea-hypo pnoea index decreased from 51.72 ± 26.45 to 12.97 ± 8.49 (P < 0.001), and the mean MSAT, Stage N3 sleep and ESS score improved significantly (P < 0.001). The postoperative sequelae were mild with 3.57 % of occasional nasal regurgitation.
CONCLUSIONS: 8-ASP is a novel, simplified and effective surgical treatment for OSAHS patients with a high success rate (85.71 %) and minimal adverse effect in selected patients, and this technique suggests a role of abduction-suspension of the palatopharyngeal muscle in the palatal surgery for OSAHS.