{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T14:30:15Z","timestamp":1791469815234,"version":"4.3.4"},"reference-count":16,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n To identify endoscopic and rhinomanometric correlation of response to 30\u00b0 head\u2010of\u2010bed elevation (HOBE) in patients with obstructive sleep apnea (OSA), and to explore whether upper airway (UA) collapse patterns and nasal resistance are associated with positional improvement.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We assessed the associations between drug\u2010induced sleep endoscopy (DISE) findings and rhinomanometric parameters with response to HOBE in OSA patients. Polysomnography was performed overnight in standardized supine, 30\u00b0 HOBE, and lateral positions. HOBE response was evaluated based on percent change in apnea\u2013hypopnea index (AHI), and correlations with VOTE collapse patterns and nasal resistance were determined.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n HOBE significantly reduced AHI from 22.6\u2009\u00b1\u20095.7 to 16.4\u2009\u00b1\u20094.9\u2009events\/h (\n p<\/jats:italic>\n \u2009<\u20090.001), with further lateral position reduction (11.7\u2009\u00b1\u20094.2,\n p<\/jats:italic>\n \u2009<\u20090.001). OSA patients demonstrated greater AHI improvement with HOBE than controls (\u221231.0% vs. \u221214.0%,\n p<\/jats:italic>\n \u2009<\u20090.001). Expiratory nasal resistance was significantly elevated in OSA patients (\n p<\/jats:italic>\n \u2009<\u20090.001) and strongly correlated with percent AHI change during HOBE (\n r<\/jats:italic>\n \u2009=\u20090.912,\n p<\/jats:italic>\n \u2009<\u20090.001). VOTE analysis revealed more severe multilevel collapse in OSA patients; epiglottic (\n r<\/jats:italic>\n \u2009=\u20090.903) and tongue base collapse scores (\n r<\/jats:italic>\n \u2009=\u20090.714) were strongly associated with the HOBE response. After adjustment for BMI and sex, epiglottic and velar collapse scores remained significantly associated with HOBE response, whereas rhinomanometric associations were attenuated and no longer statistically significant.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n DISE findings and expiratory rhinomanometric resistance values may help characterize positional responsivity to HOBE including patterns of UA collapse as well as nasal airflow resistance. However, results should be considered hypothesis\u2010generating and require confirmation in larger cohorts with prospective data collection, formal model development, and external validation.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n 3.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/lary.70893","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T10:11:22Z","timestamp":1788775882000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["DISE<\/scp>\n and Rhinomanometry Correlates of Response to Head\u2010of\u2010Bed Elevation in Obstructive Sleep Apnea"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1251-0185","authenticated-orcid":false,"given":"Antonino","family":"Maniaci","sequence":"first","affiliation":[{"name":"Department of Medicine and Surgery University of Enna \u201cKore,\u201d Enna Italy"},{"name":"Asp 7 Ragusa, Ospedale Maggiore Modica Ragusa Italy"},{"name":"Department of Surgery University of Mons (UMons) Mons Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1781-2809","authenticated-orcid":false,"given":"Giannicola","family":"Iannella","sequence":"additional","affiliation":[{"name":"Organi Di Senso Department Sapienza University of Rome Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Pelucchi","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Audiology University of Ferrara Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuele","family":"Casale","sequence":"additional","affiliation":[{"name":"Integrated Therapies in Otolaryngology Fondazione Policlinico Universitario Campus Bio\u2010Medico Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Moffa","sequence":"additional","affiliation":[{"name":"Integrated Therapies in Otolaryngology Fondazione Policlinico Universitario Campus Bio\u2010Medico Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0698-937X","authenticated-orcid":false,"given":"Alberto","family":"Caranti","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Audiology University of Ferrara Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenny P.","family":"Pang","sequence":"additional","affiliation":[{"name":"Asia Sleep Centre Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian W.","family":"Rotenberg","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Western University London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruggero","family":"Campisi","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Audiology University of Ferrara Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0845-0845","authenticated-orcid":false,"given":"Jerome Rene","family":"Lechien","sequence":"additional","affiliation":[{"name":"Organi Di Senso Department Sapienza University of Rome Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Vicini","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Audiology University of Ferrara Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213\u20102600(19)30198\u20105"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10020277"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.8752"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2013.01.005"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325\u2010025\u201003534\u20106"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325\u2010004\u20100193\u20101"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11195620"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325\u2010017\u20101524\u20103"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325\u2010001\u20100003\u2010y"},{"issue":"3","key":"e_1_2_10_11_1","first-page":"169","article-title":"Consensus Report on Acoustic Rhinometry and Rhinomanometry","volume":"43","author":"Clement P. A.","year":"2005","journal-title":"Rhinology"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12931\u2010020\u201001382\u20104"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2023.03.023"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24479"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010011\u20101633\u20108"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202011\u20104266LE"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70893","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.70893","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70893","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T10:11:23Z","timestamp":1788775883000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.70893"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,7]]},"references-count":16,"alternative-id":["10.1002\/lary.70893"],"URL":"https:\/\/doi.org\/10.1002\/lary.70893","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,7]]},"assertion":[{"value":"2026-04-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"lary.70893"}}