# Zetapalatopharyngoplasty in treatment of obstructive sleep apnea: a 10-year retrospective study

## TL;DR

Zetapalatopharyngoplasty (ZPFP) is a safe and effective surgical option for obstructive sleep apnea patients who cannot tolerate CPAP, with long-term benefits in sleep quality and daytime sleepiness.

## Contribution

This study provides a 10-year retrospective evaluation of ZPFP outcomes, demonstrating its long-term efficacy and safety in CPAP-intolerant OSA patients.

## Key findings

- ZPFP significantly reduced AHI and T90 scores, indicating improved OSA severity.
- Patients showed significant improvements in SAQLI and ESS scores, reflecting better quality of life and reduced daytime sleepiness.
- Postoperative complications were mild, with no mortality or severe adverse events reported.

## Abstract

•ZPFP surgery significantly reduced AHI and T90 scores, improving OSA severity.•A 10-year follow-up period evaluating palatoplasty outcomes.•Patients demonstrated significant enhancements in SAQLI and ESS scores.•Postoperative ZPFP complications were mild, with no mortality or severe adverse events.•Patients’ non-adherent to CPAP benefited significantly from ZPFP surgical intervention.

ZPFP surgery significantly reduced AHI and T90 scores, improving OSA severity.

A 10-year follow-up period evaluating palatoplasty outcomes.

Patients demonstrated significant enhancements in SAQLI and ESS scores.

Postoperative ZPFP complications were mild, with no mortality or severe adverse events.

Patients’ non-adherent to CPAP benefited significantly from ZPFP surgical intervention.

To evaluate the efficiency of the Zetapalatopharyngoplasty (ZPFP) technique for Obstructive Sleep Apnea (OSA).

This retrospective study included 36 adult patients treated with ZPFP between 2012 and 2023. Clinical, polysomnographic data, and subjective assessments using the Epworth Sleepiness Scale (ESS) and the Sleep Apnea Quality of Life Index (SAQLI) were analyzed. Surgical success was defined as a ≥50% reduction in the Apnea-Hypopnea Index (AHI) or a postoperative AHI <20. The mean follow-up duration was approximately 40-months.

The mean AHI decreased from 34.22 to 19.28 events/hour (p = 0.009), while desaturation time dropped from 51.09 to 17.71 min (p < 0.001). ESS scores improved from 12.36 to 6.25 (p = 0.002), indicating reduced daytime sleepiness. According to the SAQLI, 97% of patients experienced moderate to significant improvements in quality of life. Early complications included tonsillar bleeding (2.8%) and dysphagia (5.6%), while late complications involved pharyngeal reflux (8.3%) and voice changes (8.3%). Nosevere adverse events occurred.

ZPFP demonstrated favorable clinical and polysomnographic outcomes, offering a safe and effective surgical alternative for CPAP-intolerant OSA patients. Future prospective studies should assess its long-term effectiveness in reducing cardiovascular risks associated with untreated OSA.

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