title: Z-palatoplasty and tongue radiofrequency for patients with small tonsils.
abstract: OBJECTIVE
  To explore the feasibility and efficacy of Z-palatoplasty for the management of severe obstructive sleep apnea-hypopnea syndrome in patients with tonsils.
  
  
  METHODS
  Case series and chart review.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Z-palatoplasty and coblation channeling of the tongue were performed in 36 patients with body mass index <40 kg/m(2) and size 1 or 2 tonsils. All patients' tonsils were preserved. Follow-up continued for at least 1 year. Success was defined as a postoperative apnea-hypopnea index <15 events per hour and at least 50% less than the preoperative value.
  
  
  RESULTS
  The surgical success rate was 58.3% (21/36 patients). Furthermore, 66.7% (24/36 patients) had a ≥ 50% reduction in the apnea-hypopnea index to less than 20 episodes per hour. There were statistically significant differences in preoperative nadir oxygen saturation, percentage of time with oxygen saturation less than 90%, microarousal index, and Friedman tongue position between those who responded to surgery and those who did not. Six patients had temporary velopharyngeal insufficiency. After 3 months, all the patients had normal deglutition. No major perioperative complications occurred.
  
  
  CONCLUSIONS
  Our findings suggest that Z-palatoplasty can improve disease-specific quality of life and sleep apnea symptoms in patients with obstructive sleep apnea-hypopnea syndrome and size 1 or 2 tonsils.
authors: Department of Otolaryngology Head and Neck Surgery and Sleep Center, Tianjin Union Medicine Centre, Tianjin, China. tjwlin@163.com
authors: Lin
authors: L
authors: Wang
authors: Ji Xiang
authors: JX
authors: Liu
authors: Xiang Li
authors: XL
authors: Yang
authors: Chun Wei
authors: CW
authors: Yang
authors: Yong Xin
authors: YX
authors: Qin
mesh_terms: D000328:Adult; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010160:Palate, Soft / Q000601:surgery*; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D013524:Surgical Flaps; D014059:Tongue / Q000601:surgery*