Preservation Palatopharyngoplasty for Obstructive Sleep Apnea: Predictors and Clinical Outcomes.

Abstract

To evaluate clinical outcomes of Preservation Palatopharyngoplasty (PPPP), in a broader cohort, and identify predictors significantly associated with improved surgical outcomes in patients with moderate to severe obstructive sleep apnea (OSA). A retrospective cohort study. A tertiary care center. The study was conducted on adult patients with moderate to severe OSA who underwent PPPP. Objective sleep parameters and subjective symptom scores including the Epworth Sleepiness Scale (ESS), Standardized List Evaluating Apnea (SLEAP), and Nasal Obstruction Symptom Evaluation (NOSE) scale were compared pre- and postoperatively. Linear regression was performed to identify predictors of AHI reduction. A total of 53 patients (mean age 49.8 ± 12.7 years, mean BMI 35.6 ± 7.8) were included. Surgical success and cure were achieved in 88.9% and 37% of patients, respectively. Significant postoperative improvements were observed in AHI, RDI, and ODI (all P < .001), as well as in ESS, SLEAP, and NOSE scores (all P < .05). Linear regression identified higher baseline BMI, higher preoperative AHI, larger palatine tonsils, lower NOSE scores, and lateral pharyngeal wall collapse on Müller's maneuver emerged as significant predictors of AHI reduction. The PPPP is a is a tissue-preserving, safe, and effective palatal surgical technique that significantly improves both objective and subjective outcomes in patients with moderate to severe OSA. Its effectiveness extends across a wide range of BMI and baseline disease severity.