AIM: A prospective study was conducted to evaluate the outcomes of modified barbed reposition pharyngoplasty (BRP) and coblation tongue channelling (CCT) in adult patients with obstructive sleep apnoea (OSA). The study included 59 patients with complete data who had undergone this surgical technique and measured their apnoea-hypopnoea index (AHI) before and after surgery. Methodology: We conducted a prospective, 2-centre cohort trial to evaluate the outcomes of combined MODIFIED BRP and CCT in adult patients with OSA. A total of 82 patients were enrolled and underwent the surgical procedure. A single investigator performed polysomnography, Epworth sleepiness scale (ESS) and VOTE anatomy assessment before and after (3 months) the surgery. The results showed significant improvements in sleep quality, daytime alertness and upper airway anatomy. Results: This study enrolled 82 participants, of whom 76% were male and the mean age was 39.8±12.1 years. Pre- and post-operative data were available for 59 patients. Among them, 44.1% had Friedman 3 anatomy. The pre- to post-operative measurements showed statistically significant reductions in median AHI from 27.3(IQR=31.55) to 6.9(IQR=9.9) (p<0.001) and median ESS from 13 (IQR=8) to 5(IQR=3) (p<0.001). The surgical success rate and cure rate for Friedman stage 3 patients were 80.3% and 57.2%, respectively.. Conclusion: As shown by the decrease in AHI and ESS, MODIFIED BRP with CCT is a safe and very effective surgical option for patients with OSA. Friedman stage III does not limit the success of surgery anymore, so we suggest that a new staging system is needed to predict the outcomes of modern sleep surgery techniques.