Patient profiles

From January 2013 to March 2019, we retrospectively reviewed the medical records of patients who underwent sleep surgery for OSA at Severance Hospital, a tertiary referral hospital in South Korea. Inclusion criteria for patients were as follows: (1) age ≥ 19 years (2); diagnosed with OSA (apnea-hypopnea index [AHI] ≥ 5/h) using overnight polysomnography (PSG) (3); non-compliant or refused CPAP therapy, as a nonsurgical treatment (4); underwent tongue base surgery (e.g., tongue base resection using a coblator or the da Vinci robot) with or without nasal surgery (e.g., septoplasty, turbinoplasty) for OSA improvement (5); underwent preoperative nasopharyngoscopic examinations, such as MM and/or DISE; and (6) underwent postoperative PSG at 3 months or later. Patients with a history of previous airway surgery such as uvulopalatopharyngoplasty (UPPP), lateral pharyngoplasty (LP), or tonsillectomy prior to standard PSG were excluded.

Of the 137 patients who underwent sleep surgery during the period, 36 were excluded because they underwent palatal surgery (such as UPPP and LP) without the tongue base resection. Six patients were additionally excluded because of a history of previous airway surgery. Consequently, 95 OSA patients who underwent multilevel palate and tongue base surgery were included in this study.

All patients were divided into two groups according to their airway evaluation methods. Forty-seven patients comprised the MM group who underwent only MM for surgical indication, whereas 48 patients comprised the DISE group who underwent both MM and DISE.