{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:16:54Z","timestamp":1790803014130,"version":"4.1.0"},"reference-count":45,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,11,7]],"date-time":"2013-11-07T00:00:00Z","timestamp":1383782400000},"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":[[2014,3]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To systematically review outcomes for polysomnography, sleepiness, and mortality in patients who undergo tracheostomy for the treatment of adult obstructive sleep apnea (OSA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources<\/jats:title><jats:p>MEDLINE, Scopus, and the Cochrane Library were searched from inception to March 2013, followed by extensive hand searching for the identification of relevant English language studies that met predefined criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Review Methods<\/jats:title><jats:p>Adult studies of tracheostomies or tracheotomies as treatment for OSA with outcomes for apnea index (AI), apnea\u2013hypopnea index (AHI), oxygen desaturation index (ODI), effect on daytime sleepiness or mortality were identified, abstracted and pooled (as appropriate). Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses (PRISMA) guidelines were followed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The systematic search identified 18 relevant studies that were primarily case series, using retrospective review. Posttracheostomy AI improved from 73.0\u2009\u00b1\u200927.1 to 0.2\u2009\u00b1\u20091.2\/h and an AI mean difference of \u221283.47 (95% CI, \u2212106.07 to \u221260.87; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001). Mean AHI decreased from 92.0\u2009\u00b1\u200934.8 to 17.3\u2009\u00b1\u200920.5\/h and an AHI mean difference \u221279.82 (95% CI, \u221263.74 to \u221295.90; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001) compared with preoperative status was observed. Postsurgically, there was a development of central apneas; however, the central AI demonstrated near normalization to a mean of 2.1\u2009\u00b1\u20093.5\/h after 14 weeks. ODI decreased from 78.2\u2009\u00b1\u200925.8\/h to 20.8\u2009\u00b1\u200925.5\/h. Four studies demonstrated a statistically significant improvement in subjective sleepiness posttracheostomy. Postoperative statistically significant reductions in overall and in cardiovascular mortality compared with untreated historical cohorts was reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Tracheostomies significantly decrease apnea index, oxygen desaturation index, sleepiness, and mortality in OSA subjects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>NA. <jats:italic>Laryngoscope<\/jats:italic>, 124:803\u2013811, 2014<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.24433","type":"journal-article","created":{"date-parts":[[2013,11,7]],"date-time":"2013-11-07T15:33:12Z","timestamp":1383838392000},"page":"803-811","source":"Crossref","is-referenced-by-count":83,"title":["Tracheostomy as Treatment for Adult Obstructive Sleep Apnea"],"prefix":"10.1002","volume":"124","author":[{"given":"Macario","family":"Camacho","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Sleep Surgery Division Stanford University Medical Center Stanford California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Certal","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Hospital Sao Sebastiao, Sta Maria da Feira; CINTESIS\u2013Center for Research in Health Technologies and Information Systems, University of Porto Porto  Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott E.","family":"Brietzke","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Walter Reed National Military Medical Center Bethesda Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon\u2010Erik C.","family":"Holty","sequence":"additional","affiliation":[{"name":"VA Palo Health Care System, Medical Service Pulmonary, Critical Care and Sleep Medicine Section Palo 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