Effect Of Friedman Stage In UPPP/HUPPP And ZPPP Treatment For Obstructive Sleep Apnea Hypopnea Syndrome

Objective:To evaluate the effect of Friedman Stage in UPPP/HUPPP and ZPPP treatment for OSAHS. and to explore other factors affecting the outcomes of UPPP/HUPPP and ZPPP.Methods:A retrospective study was made with 140 OSAHS patients who performed UPPP/ HUPPP and ZPPP. BMI, Palate position, tonsil size, Friedman stage, AHI and LSp O2 were evaluated preoperatively. All the patients underwent PSG at least one year after surgery, AHI and LSp O2 were measured postoperatively as well. The success criteria was defined as more than 50% decreases of AHI. The effect of preoperative Friedman stage,tonsil size and palate position in surgery were evaluated.Results:The general successful rate for the total 140 patients was 55.0%. No significant difference showed in the successful rates for UPPP/ HUPPP and ZPPP,which were 53.70% and 59.38% respectively. The successful rate was 70.59% for Friedman I, 58.73% for Friedman II and 46.67% for Friedman III and no significant difference was found(?2=3.707,P=0.157). The decrease of postoperative AHI for Friedman I was significantly higher than for Friedman II & III(?AHI=42.78±29.39,F=4.097,P=0.019). For patients of same Friedman stage, there was no significant difference of successful rates in UPPP/HUPPP group and ZPPP group. No significant difference was found in general successful rates for patients with different palate positions and tonsil sizes.Conclusions:UPPP/HUPPP and ZPPP were effective treatments for OSAHS and could be an alternative for patients who can not accept CPAP therapy. Friedman stage affected the outcomes of UPPP/ HUPPP and ZPPP. However, whether Friedman stage affects the outcomes of surgery needs to be improved in further studies. There were insufficient data to support the effect of palate position and tonsil size in UPPP/HUPPP and ZPPP, and futher studies were still needed.