Modified Z-palatoplasty with one-layer closure in one-stage multilevel surgery for severe obstructive sleep apnea. Issue 4 (August 2018)

• Record Type: Journal Article
• Authors: Huang, Ethan I.; Kuo, Chia-Ling; Chou, Yu-Ting; Lin, Yu-Ching; Huang, Shu-Yi
• Is Part Of: Auris nasus larynx. Volume 45:Issue 4(2018)
• Page Start: 791
• Page End: 795
• Publication Date: 2018-08
• Subjects: Apnea–hypopnea index -- Efficacy -- Snoring -- Uvulopalatopharyngoplasty; Otolaryngology -- Periodicals; Electronic journals; 616
• DOI: 10.1016/j.anl.2017.10.002
• Languages: English
• ISSNs: 0385-8146

Abstract

Abstract: Objective: The meticulous two-layer closure is a step to complete the modified Z-palatoplasty, which has been reported to serve as an effective element in multilevel sleep surgery for patients with severe obstructive sleep apnea, especially with Friedman anatomical stages II and III diseases. A single layer closure—the suture closure as originally described in uvulopalatopharyngoplasty by Fujita et al., is an alternative of the two-layer closure, featured by simplicity while its efficacy has not been completely proved in patients with severe obstructive sleep apnea. Methods: By apnea–hypopnea index (AHI), we investigated 7 patients with severe obstructive sleep apnea undergoing the modified Z-palatoplasty with one-layer closure in a multilevel surgery. Results: The mean apnea–hypopnea index is reduced from 52.9 ± 17.1 (preoperative) to 18.4 ± 9.7 events/h (postoperative) without any wound dehiscence or bleeding that results in an unplanned return to the operating room. In comparison, the percentage of reduction in mean apnea–hypopnea index is 65%. The improvement of apnea–hypopnea index is statistically significant with the p-value 0.004. Conclusion: Our results support that one-layer closure remains the efficacy of modified Z-palatoplasty (with two-layer closure) in one-stage multilevel surgery for severe obstructive sleep apnea with an unfavorable anatomical stage.