title: A new modification of uvulopalatopharyngoplasty for the treatment of obstructive sleep apnea syndrome.
abstract: OBJECTIVE
  To evaluate objective and subjective improvement after applying a new surgical technique, two-piece palatopharyngoplasty (Two-P4), to the treatment of obstructive sleep apnea syndrome (OSAS).
  
  
  METHODS
  Twenty-four patients with mild to severe OSAS underwent Two-P4 between January 2002 and November 2007. Polysomnography and Epworth Sleepiness Scale (ESS) score were used to evaluate surgical results.
  
  
  RESULTS
  Mean apnea-hypopnea index (AHI) improved from 50.9 to 10.7 after Two-P4. Mean ESS score decreased significantly from 13.0 to 7.7. Body mass index was unchanged after surgery. Objective success as evaluated by a 50% reduction in AHI and by AHI <20 was obtained in 22 of 24 patients (91.7%). Mean reduction in AHI was 76.9% for all 24 patients, 86.2% for patients with Friedman's anatomical stage I, 78.9% for stage II, and 54.5% for stage III.
  
  
  CONCLUSIONS
  Two-P4 is a novel surgical treatment for OSAS patients with a high success rate (91.7%) as evaluated by reductions in AHI. Two-P4 keeps the middle soft palate intact to form independent scars on both sides, which constrict to stretch the soft palate and widen the pharyngeal space.
authors.affiliation: Department of Otorhinolaryngology, Shiga Hospital of Social Insurance, 16-1 Fujimidai Otsu, Shiga 520-0846, Japan. komada@mub.biglobe.ne.jp
authors.forename: Ichiro
authors.initials: I
authors.lastname: Komada
authors.forename: Soichiro
authors.initials: S
authors.lastname: Miyazaki
authors.forename: Masako
authors.initials: M
authors.lastname: Okawa
authors.forename: Michiko
authors.initials: M
authors.lastname: Nishikawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shimizu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002921:Cicatrix / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D010160:Palate, Soft / Q000601:surgery*; D010614:Pharynx / Q000601:surgery*; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D016896:Treatment Outcome; D014609:Uvula / Q000601:surgery*