Otolaryngology- Head and Neck Surgery最新文献

{"title":"Health-State Utility Values in Patients Affected by Flaccid and Non-Flaccid Facial Paralysis.","authors":"Bastien A Valencia-Sanchez, Murray J Bartho, Elise Krippaehne, Jess C Mace, Myriam Loyo","doi":"10.1002/ohn.1163","DOIUrl":"10.1002/ohn.1163","url":null,"abstract":"<p><strong>Objective: </strong>The primary goal of this study was to measure health-state utility values (HUVs) in patients with facial paralysis before and after treatment. A secondary objective was to compare these values with those of other chronic diseases and currently available treatments.</p><p><strong>Study design: </strong>A retrospective chart review.</p><p><strong>Setting: </strong>A tertiary medical center.</p><p><strong>Methods: </strong>Adults with flaccid and non-flaccid facial paralysis were included. Baseline demographics, medical comorbidities, facial paralysis history, treatment details, and disease-specific quality-of-life scores were collected. Utility values were derived using the Short-Form 6D health index at baseline and after treatment.</p><p><strong>Results: </strong>The mean baseline Short-Form 6D utility value for patients with facial paralysis (n = 134) was 0.73 (± 0.14) (95% confidence interval [CI]: 0.71-0.75). Baseline utility values significantly correlated with disease-specific quality of life as measured by the Facial Clinimetric Evaluation Scale (r = 0.400; P < .001), but not with Sunnybrook Facial Grading Scale or Synkinesis Assessment Questionnaire scores. Post-treatment utility values showed a mean improvement of 0.03 (95% CI: -0.01 to 0.08; P = .14) in the overall cohort. The flaccid group showed a greater average improvement compared to the non-flaccid group (0.05 [± 0.17] vs 0.02 [± 0.17]; P = .62).</p><p><strong>Conclusion: </strong>Patients with flaccid and non-flaccid facial paralysis reported HUVs that were significantly lower than the US population norm. Treatment improved utility values in both groups. These findings provide initial data for future cost-effectiveness analyses of surgical and non-surgical treatment options for facial paralysis.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1570-1578"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Trends in Medicare Reimbursements Between Male and Female Otolaryngologists From 2013 to 2018.","authors":"Corinne A Pittman, Holly D Shan, Varsha Harish, Sarah K Rapoport","doi":"10.1002/ohn.1157","DOIUrl":"10.1002/ohn.1157","url":null,"abstract":"<p><strong>Objective: </strong>Gender-based pay disparities exist in otolaryngology. Determining whether such patterns have been consistently present could help expose whether, and to what extent, gender-based inequalities exist within our field.</p><p><strong>Study design: </strong>Retrospective, cross-sectional analysis of publicly available Centers for Medicare and Medicaid Services (CMS) data for otolaryngologists from 2013 to 2018.</p><p><strong>Setting: </strong>A database study.</p><p><strong>Methods: </strong>CMS databases were used to evaluate whether gender differences exist within clinical productivity and reimbursement patterns among otolaryngologists over time, and if so, what those trends have been. Outcomes included the number of unique billing codes and charges submitted per physician (clinical productivity) and physician reimbursements. Results were controlled for geography, levels of clinical productivity, and gender.</p><p><strong>Results: </strong>Male otolaryngologists consistently submitted more charges for reimbursement (median [interquartile range, IQR], 291,539 [154,380-503,932] vs 196,029 [94,849-337,224]) and a greater number of unique billing codes (median [IQR], 52.0 [34.0-72.0] vs 41.0 [27.0-59.0]) than female otolaryngologists. Male otolaryngologists received greater reimbursements than female otolaryngologists (median [IQR], $114,390 [$61,732-$184,209] vs $72,679 [$34,855-$122,473]). Contrast ratios of estimated marginal means for reimbursements between male and female otolaryngologists demonstrated that 75% to 81% (P < .0001) of the estimated payment for physician services were received by male otolaryngologists.</p><p><strong>Conclusion: </strong>There appears to be a consistent, general trend that the female gender is associated with decreased clinical productivity and lower CMS payments among otolaryngologists. These disparities persist even among highly productive female otolaryngologists. To better address gender pay disparities within otolaryngology, billing patterns among female otolaryngologists should be more closely assessed to help optimize reimbursement patterns for equivalent services provided by male otolaryngologists.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1625-1632"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hearing Preservation Techniques in Pediatric Cochlear Implantation: A Systematic Review and Meta-Analysis.","authors":"Ory Madgar, Amber D Shaffer, Daniel Gerges, Dennis J Kitsko, David H Chi","doi":"10.1002/ohn.1180","DOIUrl":"10.1002/ohn.1180","url":null,"abstract":"<p><strong>Objective: </strong>Preserving residual hearing following cochlear implantation (CI) improves outcomes and allows patients to use electrical and acoustic stimulation. Hearing preservation and minimizing intracochlear trauma during implantation have become key areas of research and device development in recent years. This meta-analysis evaluated whether patient characteristics or surgical methodology impact hearing preservation postpediatric CI.</p><p><strong>Data sources: </strong>A systematic search was performed in PubMed, Web of Science, Cochrane Library, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature.</p><p><strong>Review methods: </strong>Per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the databases were searched for English studies published before August 2024. Search terms were \"hearing preservation,\" \"cochlear implant,\" \"audiometry,\" and \"pediatric\" and their synonyms. The main outcome was the percentage of ears with hearing preservation after CI. Patient, audiological, device, and surgical technique characteristics were extracted. The impact of these factors on hearing preservation was evaluated.</p><p><strong>Results: </strong>Twenty-four studies were included, with a total of 567 patients. Males comprised 50% of patients (95% confidence interval [CI]: 45%-55%). Mean patient age was 9.68 years (95% CI: 8.27-11.09 years). Mean pure tone averages (PTAs) before and after CI were 60.48 dB (95% CI: 48.81-72.14 dB) and 70.95 dB (95% CI: 56.75-85.15 dB), respectively. Hearing preservation was reported in 78% of ears (95% CI: 71%-85%), with high heterogeneity between studies (I² = 79.96%). Gender, surgical approach, electrode array, topical corticosteroids, and initial PTA were not significantly associated with hearing preservation.</p><p><strong>Conclusions: </strong>Hearing preservation following pediatric CI occurred in 78% of ears. In this meta-analysis, no patient characteristic or surgical technique was significantly associated with hearing preservation.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1539-1547"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of Optokinetic Nystagmus in Healthy Participants With a Novel Oculography Device.","authors":"Mitali Sakharkar, Parth K Jalihal, Kimberly Ramirez, Faisal Karmali, Richard F Lewis, Divya A Chari","doi":"10.1002/ohn.1148","DOIUrl":"10.1002/ohn.1148","url":null,"abstract":"<p><strong>Objective: </strong>To develop a proof-of-concept smart-phone-based eye-tracking algorithm to assess non-pathologic optokinetic (OKN) nystagmus in healthy participants. Current videonystagmography (VNG) is typically restricted to in-office use, and advances in portable vestibular diagnostics would yield immense public health benefits.</p><p><strong>Study design: </strong>Prospective cohort study.</p><p><strong>Setting: </strong>Tertiary academic medical center.</p><p><strong>Methods: </strong>Healthy participants (n = 39) without dizziness or vertigo were recruited. A smart-phone attached to a custom head stabilization device illuminated by a white LED circuit was used to record nystagmus induced with a 30 frames per second OKN stimulus over a 60-second period. A centroid tracking algorithm was created to detect slow-phase velocity (SPV) of horizontal nystagmus in a diverse subject cohort in a variety of lighting conditions. Nystagmus recordings were compared to those obtained with a standard VNG system.</p><p><strong>Results: </strong>Non-pathologic nystagmus from an OKN stimulus was measured across multiple lighting conditions, with high signal-to-noise ratios (SNR) and mean SPV 22.13 ± 5.26°/s. Nystagmus SPV was not significantly different between the device and standard VNG system (t = -0.5, P = .6). Lighting conditions produced SNRs of 57.30 (ideal), 50.59 (backlit), 51.33 (side-lit), 49.28 (dark), 54.52 (outdoor lighting).</p><p><strong>Conclusion: </strong>We demonstrate the feasibility of a novel portable oculography system in the detection of non-pathologic nystagmus in healthy subjects. Future applications of this system include: (1) to obtain real-time measurements of nystagmus during an acute vertigo attack; (2) to test patients unable or unwilling to present to a specialized vestibular laboratory; (3) to efficiently repeat testing overtime; (4) to improve accessibility of vestibular testing.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1692-1702"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trilayer Temporalis Fascia Interposition Graft for Nasal Septal Perforation Repair: A Continued Experience.","authors":"Derek J Vos, Kristen A Echanique, Amit Nag, Stephen Hadford, Peter Ciolek, Dane J Genther","doi":"10.1002/ohn.1183","DOIUrl":"10.1002/ohn.1183","url":null,"abstract":"<p><strong>Objective: </strong>The repair of nasal septal perforation (NSP) is complex, with a variety of described techniques and reported outcomes. At our institution, we commonly perform NSP repair using a trilayer graft of thin polydioxanone (PDS) plate wrapped on both sides with temporalis fascia without intranasal flaps. We aim to report our continued experience with this technique.</p><p><strong>Study design: </strong>Retrospective chart review.</p><p><strong>Setting: </strong>Single institution.</p><p><strong>Methods: </strong>Retrospective chart review of patients undergoing repair of NSP using a trilayer temporalis fascial interposition grafting technique at our institution from 9/1/2018 to 10/31/2023.</p><p><strong>Results: </strong>Fifty-six patients (mean age 45 years, 58.9% female) were included in this study. The suspected cause of NSP was primarily iatrogenic (n = 26, 45.6%); however, a large number of patients did not have a definitive etiology of NSP (n = 18, 32.1%). The most commonly reported symptoms pre-operatively included nasal obstruction/congestion (n = 51, 91.1%) and nasal crusting (n = 31, 55.4%). NSPs were most frequently anterior in location (n = 46, 82.1%) and medium in size (1-2 cm) (n = 31, 55.4%), followed by small (<1 cm) (n = 17, 30.4%). All patients within this study experienced improvement in their pre-existing symptoms associated with NSP, with complete resolution of prior symptoms occurring in the majority of patients (n = 44, 78.6%). A minority of patients in this cohort experienced postoperative complications (n = 8, 14.3%). One patient (1.8%) demonstrated persistent perforation following repair. The median length of follow-up in this study was 257 days (range 65-1724).</p><p><strong>Conclusion: </strong>The trilayer temporalis fascial interposition graft is an effective and reliable tool for the repair of NSP.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1601-1607"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographic Accessibility to Clinical Trials for Head and Neck Cancers in the United States.","authors":"Shiven Sharma, Dany Alkurdi, Ezdean Alkurdi, Dev Patel, Omar Alani, Keshav Sharma, Ekambir Saran, Michele M Carr","doi":"10.1002/ohn.1168","DOIUrl":"10.1002/ohn.1168","url":null,"abstract":"<p><p>Head and neck cancers (HNCs) are becoming more common, thereby gaining greater attention within the medical community. This retrospective trend analysis examined geographical access to HNC clinical trials in the United States from 2005 to 2024, utilizing Census data and the Haversine formula. A search of ClinicalTrials.gov identified 23,450 trial sites, with 18,394 initiated before 2020. Although linear regression revealed a slight annual increase in trial initiation (37.947 trials/year, R² = 0.014, P = .625), most observed trends did not reach statistical significance. The proportion of the population residing within 1 mile of the trials saw a minor increase (0.328%/year, R² = 0.178, P = .064). Accessibility remained consistent throughout the COVID-19 pandemic, despite a decline in trial initiation during 2020. Enhancing access to trials, especially for marginalized populations, could improve patient engagement and clinical results.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1797-1800"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eustachian Tube Dysfunction in Adhesive Otitis Media: Obstructive Versus Patulous Types.","authors":"Seong Hoon Bae, Tae Uk Cheon, Sung Il Cho, Gi-Sung Nam","doi":"10.1002/ohn.1169","DOIUrl":"10.1002/ohn.1169","url":null,"abstract":"<p><strong>Objective: </strong>Understanding the distinct subtypes of adhesive otitis media (AdOM) is crucial for appropriate treatment such as balloon Eustachian tuboplasty (BET), particularly in distinguishing between patulous and obstructive Eustachian tube (ET) function. Nevertheless, AdOM caused by patulous Eustachian tube dysfunction (ETD) remains underexplored. This study aims to describe the detailed characteristics and define the patulous type of AdOM associated with patulous ETD (PET).</p><p><strong>Study design: </strong>A prospective cohort study.</p><p><strong>Setting: </strong>A total of 62 ears of patients diagnosed with AdOM, PET, and traumatic perforation were included from a tertiary referral center (university hospital).</p><p><strong>Methods: </strong>Obstructive-AdOM, patulous-AdOM, PET, and a control group with traumatic perforation patients underwent endoscopic examinations, completed symptom questionnaires, and had passive ET opening pressure evaluated using a modified inflation-deflation test following tympanostomy tube insertion.</p><p><strong>Results: </strong>Patulous-AdOM was identified in 43% of the patients and was characterized by significantly lower median opening pressures (222 daPa) than those in patients with obstructive-AdOM (400 daPa) and PET (below 100 daPa). Habitual sniffing was reported in 92.3% of patients with patulous-AdOM, and reduced mastoid pneumatization was observed in both the patulous and obstructive subtypes.</p><p><strong>Conclusion: </strong>Accurate differentiation between patulous-AdOM and obstructive-AdOM is essential because BET may exacerbate symptoms in patients with patulous characteristics. A comprehensive evaluation of ET function is critical before initiating treatment, underscoring the need for tailored approaches to manage AdOM.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1633-1639"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Patient Satisfaction in Voice Feminization Procedures: A Systematic Review and Meta-Analysis.","authors":"Kristopher Lanham, Bradley A Melnick, Madeline J O'Connor, Angelica Bartler, Rolando J Casas Fuentes, Kelly C Ho, Robert D Galiano","doi":"10.1002/ohn.1173","DOIUrl":"10.1002/ohn.1173","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and quality of life impact of voice feminization interventions in transgender women.</p><p><strong>Data sources: </strong>We searched PubMed, EMBASE, Scopus, and Web of Science for RCTs and retrospective studies published between 2008 and 2023 that quantitatively evaluated any voice feminization procedure.</p><p><strong>Review methods: </strong>Studies in English reporting quantitative measures of efficacy were included. Studies using qualitative methodology were excluded. Risk of bias was assessed using Cochran tools and a random-effects model was applied using inverse-variance pooling. Primary outcomes were fundamental frequency [F0]/speaking fundamental frequency [SF0] and patient-reported outcomes (PROs) (PROSPERO: CRD42023476192).</p><p><strong>Results: </strong>Twenty-four studies involving 893 participants showed significant SF0 improvements for voice therapy (VT, g = 0.86, [0.46, 1.26], P < .0001), Wendler glottoplasty (WG, g = 1.21, [0.65, 1.77], P < .0001), feminization laryngoplasty (FL, g = 3.05, [2.24, 3.86], P < .0001), and laser reduction glottoplasty (LRG, g = 12.28, [8.19, 15.64], P < .0001). PROs indicated enhanced quality of life for VT (g = 1.32, [0.68, 1.96], P < .0001), WG (g = 1.82, [1.07, 2.57], P < .0001), and LRG (g = 1.90, [0.72, 3.07], P = .0015), with a strong correlation between pitch alteration and QoL (r² = 0.83, P = .0001).</p><p><strong>Conclusion: </strong>Our results indicate that both VT and surgical procedures enhance vocal pitch and strongly correlate with improved QoL. Our findings validate the role of voice feminization in gender-affirming care, though methodological limitations prevent evaluation of newer interventions.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1521-1538"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Creative Activities to Improve the Postoperative Experience of Adult Patients.","authors":"Sana Batool, Ashish Dahal, Tejas S Athni, James G Naples","doi":"10.1002/ohn.1208","DOIUrl":"10.1002/ohn.1208","url":null,"abstract":"<p><p>Unlike pediatric care that often benefits from child-life services, adult hospitals rarely offer structured engagement activities for postsurgical patients. To address this, we conducted a prospective, randomized survey-based study to evaluate the impact of creative engagement activities on adult inpatient experiences. Patients undergoing surgery between January and September 2023 were randomly assigned to either standard postoperative course or one that received an entertainment packet. Both cohorts completed a survey about their hospital experience. The intervention group reported significantly higher satisfaction: 95% agreed or strongly agreed with \"I am satisfied with my hospital experience,\" compared to 65% in the control group (P = .045). Additionally, 65% of the intervention cohort reported a positive postoperative experience and 80% found their stay engaging versus 30% in the control cohort (P = .028 and P = .001, respectively). These findings suggest that creative entertainment can improve the postoperative experience for adult patients.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1801-1804"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in Hypoxemia Metrics After Upper Airway Surgery for Obstructive Sleep Apnea.","authors":"Praneet C Kaki, Jennifer A Goldfarb, Natalie P Snyder, Elliott M Sina, Thomas M Kaffenberger, Erin Creighton, Nicole Molin, Maurits Boon, Colin Huntley","doi":"10.1002/ohn.1182","DOIUrl":"10.1002/ohn.1182","url":null,"abstract":"<p><strong>Objective: </strong>The apnea-hypopnea index (AHI) quantifies obstructive sleep apnea (OSA) severity but has limited correlation with subjective symptoms and cardiovascular risk. Sleep parameters related to oxygenation status and hypoxic burden may offer utility as additional predictors of cardiovascular risk and the physiologic consequences of OSA. This study aims to assess the change in measures of oxygenation status following sleep surgery for OSA.</p><p><strong>Study design: </strong>A retrospective cohort study.</p><p><strong>Setting: </strong>A single-institution tertiary care center.</p><p><strong>Methods: </strong>Patients who underwent hypoglossal nerve stimulator (HGNS) placement, expansion sphincter pharyngoplasty (ESP), or maxillomandibular advancement (MMA) for continuous positive airway pressure-intolerant OSA were included. The percentage of sleep time below SaO₂ 90% (pT90) was used to characterize oxygenation status. Wilcoxon signed-rank test compared changes in sleep metrics from preoperatively to postoperatively. Linear regression was performed to assess whether changes in pT90 were correlated with changes in AHI and Epworth Sleepiness Scale (ESS), respectively.</p><p><strong>Results: </strong>A total of 219 patients were included (65% HGNS, 24% ESP, 11% MMA). The average decline in AHI and ESS was 11.9 events/h (standard deviation [SD] = 19.9, P < .001) and 3.2 points (SD = 4.7, P < .001), respectively. Among measures of sleep oxygenation, pT90 (11.5 → 8.9, P < .001), oxygen desaturation index (27.1 → 15.1, P < .001), and SpO₂ nadir (79.9 → 81.2, P = .03) improved significantly following surgery. On linear regression, changes in pT90 were significantly correlated with changes in AHI (β = 0.31, 95% confidence interval [CI] 0.18-0.45, P < .001) and ESS (β = .05, 95% CI 0.00, 0.09, P = .038), respectively.</p><p><strong>Conclusion: </strong>Upper airway surgery improves metrics of oxygen status in addition to the AHI. Changes in pT90 correlate with subjective symptoms of OSA per ESS, suggesting utility in capturing disease burden.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1781-1788"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}