[Effectiveness and related factors of Z-palatopharyngoplasty for treating obstructive sleep apnea hypopnea syndrome].
OBJECTIVE
To investigate the efficacy and related factors of Z-palatopharyngoplasty for treating severe obstructive sleep apnea hypopnea syndrome (OSAHS).


METHODS
Thirty four OSAHS patients with graded 1-3 tonsil, posterior airway space (PAS) > or = mm , Friedman II and III oropharyngeal airway were included in this study, all cases had Z-palatopharyngoplasty. The follow up was at least 6 months postoperatively. Measurement parameters of responders and nonresponders were analyzed.


RESULTS
According to related criterion of China, cure rate was 35.3%, accumulative total excellence rate 64.7% and accumulative valid rate 70. 6%. The cured and excellence patients were considered as responders, the other as nonresponders. The lowest oxygen saturation (LSaO2), percentage of time with oxyhemoglobin saturation below 0.90 (CT90), mandibular plane angle (MPA), mandibular body length, position of tongue and Friedman clinical stage are statistically significant between responder and nonresponder. The best cut points of LSaO2, CT90 and MPA were 0.72, 22.80% and 29.40 degrees respectively. The logistic regression showed that Friedman stage and MPA entered into equation, which was Y = ln [P/(1-P)] = -122.85 + 31.57X1 + 1.01X2, if setting X1 as Friedman stage, and X2 as MPA.


CONCLUSIONS
Z-palatopharyngoplasty is effective surgical approach for OSAHS patients with posterior airway space (PAS) > or = 11 mm. The affective factors of Z-palatopharyngoplasty included LSaO2, CT90, MPA, mandibular body length, position of tongue and Friedman clinical stage. Among them, the mandibular plane angle and Friedman clinical stage were predominant factors.
Yi
Hong-liang
HL
Department of Otorhinolaryngology, Affiliated Shanghai Sixth People's Hospital of Shanghai Jiao Tong University, Shanghai 200233, China.
Yin
Shan-kai
SK
Zhang
Yu-jun
YJ
Chen
Bin
B
Lu
Wen-ying
WY
Sun
Xiao-qiang
XQ
Cao
Zhen-yu
ZY
Wu
Hong-min
HM
Guan
Jian
J
D000328:Adult; D001049:Apnea / Q000601:surgery; D002972:Cleft Palate / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D010614:Pharynx / Q000601:surgery; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D016896:Treatment Outcome; D014609:Uvula / Q000601:surgery