Trends in otolaryngology residency training in the surgical treatment of obstructive sleep apnea

Sim, Michael W.; Stanley, Jeffrey J.

doi:10.1002/lary.24325

Cited by 20 publications

(26 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A recent survey of 103 accredited Otolaryngology residency program directors in the United States revealed high rates of resident surgical competency in oropharyngeal procedures (100% for UPPP) and lesser competency in hypopharyngeal procedures. 13 Practice patterns among practicing surgeons self-identified as having a special interest in sleep medicine revealed that only 39% believed their residency training in OSA surgery was of high quality and greater than 40% reported receiving limited training in hypopharyngeal procedures, with the exception of radiofrequency tongue ablation. 14 During the past two decades, there has been increased awareness of multilevel obstruction in patients with OSA.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of oral appliance therapy in patients following uvulopalatopharyngoplasty failure

Stanley

Shelgikar

Aronovich

et al. 2019

Laryngoscope Investig Oto

Self Cite

View full text Add to dashboard Cite

Objective Uvulopalatopharyngoplasty (UPPP) is the most common surgical procedure performed to treat obstructive sleep apnea (OSA). This surgery, when performed alone, benefits only a minority of patients. This study was undertaken to determine the efficacy of oral appliance (OA) therapy following unsuccessful UPPP and assess for specific patient and polysomnographic characteristics that may identify those patients most likely to benefit from this combined treatment strategy. Study Design Retrospective of clinical outcomes in patients undergoing UPPP followed by treatment with an OA. Methods Polysomnographic results (baseline, status post‐UPPP, and status post‐UPPP with oral appliance use), age, gender, race, and body mass index were subjected to statistical analysis. Results The mean apnea hypopnea index (AHI) decreased from 23.6 at baseline to 8.6 following UPPP and oral appliance therapy. The mean O2 nadir increased from 83% at baseline to 89.9% following UPPP and treatment with an oral appliance. Fifty percent of patients (9/18) achieved an AHI <5 and were deemed “cured” of their disease. Seventy‐three percent of patients (13/18) achieved benefit with an AHI <20 and ≥50% reduction in their baseline AHI, deemed “successful therapy.” No statistically relevant demographic or polysomnographic differences were found between those who were “cured” and those with persistent disease with the exception that the O2 nadir status post UPPP was found to be lower in the “cured” group. Conclusion Oral appliance therapy is an effective treatment option for the majority of patients who have persistent obstructive sleep apnea following unsuccessful UPPP. Level of Evidence 4

show abstract

Section: Discussionmentioning

confidence: 99%

Efficacy of oral appliance therapy in patients following uvulopalatopharyngoplasty failure

Stanley

Shelgikar

Aronovich

et al. 2019

Laryngoscope Investig Oto

Self Cite

View full text Add to dashboard Cite

show abstract

“…Its introduction into otolaryngology residency training and the development of various sleep surgeries may have contributed to the rise in the number of procedures performed over the course of the study period. Accordingly, a recent survey of otolaryngology residency program directors has shown a significant increase in competence among residents in oropharyngeal and hypopharyngeal procedures for OSA from 2000 to 2010 . Despite this increase in sleep surgery education and experience, many feel there is still room for improvement in resident exposure to sleep surgery …”

Section: Discussionmentioning

confidence: 99%

“…Accordingly, a recent survey of otolaryngology residency program directors has shown a significant increase in competence among residents in oropharyngeal and hypopharyngeal procedures for OSA from 2000 to 2010. 27 Despite this increase in sleep surgery education and experience, many feel there is still room for improvement in resident exposure to sleep surgery. 28 T&A continues to be the most common surgical procedure performed for children with OSA, and is currently recommended as the first-line treatment for those with adenotonsillar hypertrophy by the AAP.…”

Section: Discussionmentioning

confidence: 99%

Down syndrome and pediatric obstructive sleep apnea surgery: A national cohort

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Two 2013 studies noted potential benefits of nasal surgery, one in improving patient compliance with CPAP [74] and another in subjective symptoms of sleep disordered breathing such as sleepiness and quality of life [75]. Enhancement of residency training in the surgical treatment of obstructive sleep apnea, particularly regarding current practice recommendations for multilevel treatment of OSA [76], should assure continued progress in OSA surgery.…”

Section: Progress In Surgical Treatment Of Osamentioning

confidence: 99%

Obstructive Sleep Apnea and Surgery: Quality Improvement Imperatives and Opportunities

Brenner

Goldman

2014

Curr Otorhinolaryngol Rep

View full text Add to dashboard Cite

Obstructive sleep apnea (OSA) is more common in surgical candidates than in the general population and may increase susceptibility to perioperative complications that range from transient desaturation to catastrophic injuries. Understanding the potential impact of OSA on patients’ surgical risk profile is of particular interest to otolaryngologists, who routinely perform airway procedures—including surgical procedures for treatment of OSA. Whereas the effects of OSA on long-term health outcomes are well documented, the relationship between OSA and surgical risk is not collinear, and clear consensus on the nature of the association is lacking. Better guidelines for optimization of pain control, perioperative monitoring, and surgical decision making are potential areas for quality improvement efforts. Many interventions have been suggested to mitigate the risk of adverse events in surgical patients with OSA, but wide variations in clinical practice remain. We review the current literature, emphasizing recent progress in understanding the complex pathophysiologic interactions noted in OSA patients undergoing surgery and outlining potential strategies to decrease perioperative risks.

show abstract

Trends in otolaryngology residency training in the surgical treatment of obstructive sleep apnea

Abstract: 3b.

Cited by 20 publications

References 11 publications

Efficacy of oral appliance therapy in patients following uvulopalatopharyngoplasty failure

Efficacy of oral appliance therapy in patients following uvulopalatopharyngoplasty failure

Down syndrome and pediatric obstructive sleep apnea surgery: A national cohort

Obstructive Sleep Apnea and Surgery: Quality Improvement Imperatives and Opportunities

Contact Info

Product

Resources

About