Z-palatoplasty (ZPP): A technique for patients without tonsils
Z-palatoplasty (ZPP): A technique for patients without tonsils
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DOI：
10.1016/j.otohns.2004.02.051
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发表时间：
2004-07-01
影响因子：
3.4
通讯作者：
Joseph, NJ
中科院分区：
文献类型：
--
作者：
Friedman, M;Ibrahim, HZ;Joseph, NJ
目标。无扁桃体和Friedman舌位(FTPIII和IV)的患者不适合悬雍垂腭咽成形术(UP3)。即使与辅助下咽技术相结合，效果也很差。我们评估了一种基于双侧Z成形术的改良悬雍垂腭成形术，用于治疗患有阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的无扁桃体的患者。方法：25例采用改良技术的患者与25例传统的UP3患者进行配对。两组患者均接受了射频舌根复位术。比较两组患者手术前后客观治疗成功率和主观症状的差异。观察两组患者疼痛程度、麻醉药物使用、恢复固体饮食和正常活动情况及并发症的发生率。结果：两组患者主观症状改善均较好，但客观临床改善情况试验组明显优于对照组。试验组的发病率和并发症与对照组和UP3上发表的其他系列相似。结论针对无扁桃体的OSAHS患者，提出了一种改进的手术方法。与传统技术相比，新技术更成功，OSAHS患者的发病率可接受。
OBJECTIVE. Patients without tonsils and with Friedman tongue position (FTP) III and IV are poor candidates for uvulopalatopharyngoplasty (UP3). Even when combined with adjunctive hyopharyngeal techniques, results are poor. We assessed a modified uvulopalatoplasty based on a bilateral Z-plasty in treating patients without tonsils who have obstructive sleep apnea/hypopnea syndrome (OSAHS).METHODS: 25 patients treated with a modified technique were matched with 25 patients previously treated with classic UP3. All patients in both groups also had radiofrequency tongue base reduction. Preoperative vs. postoperative measures of objective treatment success and subjective symptoms were compared for the 2 groups. Morbidity, including pain levels, narcotic use, and return to solid diet and normal activity, as well as complications were studied.RESULTS: Subjective improvement was good for both groups, but objective clinical improvement was significantly better for the experimental group. Morbidity and complications for the experimental group were comparable to the control group and to other published series on UP3.CONCLUSIONS. A modified technique for patients without tonsils who have OSAHS is presented. The new technique is more successful with acceptable morbidity for patients with OSAHS than classical techniques.