{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T19:59:35Z","timestamp":1788983975742,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2010,6,18]],"date-time":"2010-06-18T00:00:00Z","timestamp":1276819200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2010,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives\/Hypothesis:<\/jats:title><jats:p>To evaluate the impact of multilevel obstructive sleep apnea surgical treatment on sleep\u2010disordered breathing severity, health\u2010related measures, and quality of life, and to examine the association between changes in sleep\u2010disordered breathing severity and these other outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design:<\/jats:title><jats:p>Prospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>Subjects with obstructive sleep apnea unable to tolerate positive airway pressure therapy and with evidence of multilevel (palate and hypopharynx) obstruction underwent uvulopalatopharyngoplasty, tonsillectomy, and genioglossus advancement, with or without hyoid suspension. All subjects had preoperative and postoperative study assessments, including blood draw for C\u2010reactive protein, interleukin\u20106, homocysteine, homeostasis model of insulin resistance, and leptin, and evaluation with the Functional Outcomes of Sleep Questionnaire.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>Thirty subjects underwent multilevel surgical treatment. The mean apnea\u2010hypopnea index decreased from 44.9 \u00b1 28.1 to 27.8 \u00b1 26.4 events\/hour (<jats:italic>P<\/jats:italic> = .008). Thirteen (43%) subjects in this heterogeneous sample achieved a response to surgery (defined as an apnea\u2010hypopnea index reduction of \u226550% to an absolute level &lt;15 events\/hour), and body mass index \u226432 kg\/m<jats:sup>2<\/jats:sup> was associated with a higher likelihood (55%, 12\/22) of response (<jats:italic>P<\/jats:italic> = .04). There was no overall change in C\u2010reactive protein levels, but responders demonstrated a decrease (\u22121.02 \u00b1 0.98 mg\/L, <jats:italic>P<\/jats:italic> = .003) that was independent of changes in body weight. There were no significant changes in other health\u2010related measures. Responders and nonresponders both demonstrated improvements in sleep\u2010related quality of life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>This multilevel surgery was associated with a low likelihood of response in subjects with body mass index &gt;32 kg\/m<jats:sup>2<\/jats:sup>. Responders had decreased C\u2010reactive protein levels that were independent of changes in body weight. Laryngoscope, 2010<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.20946","type":"journal-article","created":{"date-parts":[[2010,6,18]],"date-time":"2010-06-18T16:58:44Z","timestamp":1276880324000},"page":"1481-1488","source":"Crossref","is-referenced-by-count":42,"title":["Changes in obstructive sleep apnea severity, biomarkers, and quality of life after multilevel surgery"],"prefix":"10.1002","volume":"120","author":[{"given":"Eric J.","family":"Kezirian","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atul","family":"Malhotra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew N.","family":"Goldberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David P.","family":"White","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2010,6,25]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000053730.47739.3C"},{"key":"e_1_2_6_3_2","first-page":"835","article-title":"An instrument to measure functional status outcomes for disorders of excessive sleepiness","volume":"20","author":"Weaver TE","year":"1997","journal-title":"Sleep"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1067\/mhn.2002.126477"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2010.26"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2009.01.012"},{"key":"e_1_2_6_7_2","volume-title":"The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology, and Technical Specifications","author":"Iber C","year":"2007"},{"key":"e_1_2_6_8_2","unstructured":"Department of Health and Human Services Centers for Medicare and Medicaid Services. 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