A novel palatal implant surgery combined with uvulopalatopharyngoplasty and inferior turbinate radiofrequency for the treatment of moderate to severe obstructive sleep apnea: a pilot study

The efficacy of Pillar implant system for the treatment of obstructive sleep apnea–hypopnea syndrome (OSAHS) is limited. The aim of this study is to explore a new type of soft palatal surgery for the treatment of adult OSAHS, and describe the subjective and objective results of this new surgery combined with uvulopharyngoplasty and inferior turbinate radiofrequency, and assess its safety and feasibility. Pre-operative preparation and risk assessment were conducted following the guidelines for uvulopalatopharyngoplasty surgery. At the follow-up visits 6 and 12 months after surgery, polysomnography and video laryngoscope examination were performed, and the snoring visual analog scale (VAS) and Epworth Sleepiness Scale (ESS) were used to assess the success of the treatment. The median apnea–hypopnea index (AHI) was 16.0 at 6 months and 20.9 at 12 months after the operation. The pre-operative median LSaO₂, 74.0, was significantly increased to 82 at 6 months and 80 at 12 months after the operation. VAS was significantly decreased from the pre-operative median of 8.0 to 3.0 and 3.0 at 6 and 12 months after the operation, respectively. ESS was significantly decreased from the pre-operative median of 10.0 to 5.0 and 6.0 at 6 and 12 months after the operation, respectively. The soft palate support surgery is less invasive and has a mild postoperative reaction, few complications and adverse reactions, and good graft safety. Its short-term efficacy is good in patients with moderate to severe OSAHS and velopharyngeal obstruction.