{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T10:49:58Z","timestamp":1777027798712,"version":"3.51.4"},"reference-count":13,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,5,20]],"date-time":"2015-05-20T00:00:00Z","timestamp":1432080000000},"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":[[2016,1]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To illustrate the reliability of the Pang\u2010Rotenberg (PR) sign as a prognosticator of snoring surgery. Our hypothesis was that patients who are PR\u2010positive have better snoring reduction scores and outcomes than PR\u2010negative patients after nose and palate surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>A multicenter prospective series of 153 patients with snoring.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients graded the snoring intensity on a visual analog scale (VAS). All 137 patients enrolled had both the nose surgery and palate surgery. The control group consisted of 16 patients who underwent nasal surgery alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 122 men and 15 women, the mean age was 44.6 years old, and mean body mass index was 26.1. There were 15 simple snorers and 122 obstructive sleep apnea patients. Patients who were PR\u2010positive showed significantly better postoperative snoring VAS reduction (from 9.04 to 1.02) compared to those patients who were PR\u2010negative (from 8.91 to 3.14) (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). The mean follow\u2010up time was 7.4 months. The control group had poor snoring VAS reduction from 9.21 to 6.72. After adjusting for covariates that influence the snoring VAS change due to surgery, we found that PR\u2010negative patients achieved an average of 5.78 improvement in snoring VAS, whereas PR\u2010positive patients achieved an average of 8.02 improvement in snoring VAS (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The PR sign is a reliable prognosticator of snoring reduction, after combined nose and palate surgery, for patients with troublesome snoring.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2b <jats:italic>Laryngoscope<\/jats:italic>, 126:260\u2013265, 2016<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.25392","type":"journal-article","created":{"date-parts":[[2015,5,20]],"date-time":"2015-05-20T06:42:45Z","timestamp":1432104165000},"page":"260-265","source":"Crossref","is-referenced-by-count":11,"title":["<scp>P<\/scp>ang\u2010<scp>R<\/scp>otenberg sign\u2014snoring surgery prognosticator: A prospective clinical trial of 153 patients"],"prefix":"10.1002","volume":"126","author":[{"given":"Kenny P.","family":"Pang","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Asia Sleep Centre Paragon Medical Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Srivinas","family":"Kishore","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Nova Specialty Hospital Hyderabad India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph Chung Chun","family":"Kit","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Tuen Mun Hospital Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward B.","family":"Pang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Asia Sleep Centre Paragon Medical Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiong Huak","family":"Chan","sequence":"additional","affiliation":[{"name":"Biostatistics Unit Dean's Office School of Medicine National University  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siow Jin","family":"Keat","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Tan Tock Seng Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Rotenberg","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Western University London Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,5,20]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199304293281704"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/20.9.705"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-996950"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(00)70147-1"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200201000-00012"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1986.60.6.1882"},{"key":"e_1_2_6_8_1","first-page":"189","article-title":"The importance of nasal resistance in OSA","volume":"21","author":"Kerr P","year":"1992","journal-title":"J 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