{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:34:16Z","timestamp":1761006856836,"version":"build-2065373602"},"reference-count":36,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T00:00:00Z","timestamp":1741305600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The apnea\u2013hypopnea index (AHI) quantifies obstructive sleep apnea (OSA) severity but has limited correlation with subjective symptoms and cardiovascular risk. Sleep parameters related to oxygenation status and hypoxic burden may offer utility as additional predictors of cardiovascular risk and the physiologic consequences of OSA. This study aims to assess the change in measures of oxygenation status following sleep surgery for OSA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>A retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>A single\u2010institution tertiary care center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who underwent hypoglossal nerve stimulator (HGNS) placement, expansion sphincter pharyngoplasty (ESP), or maxillomandibular advancement (MMA) for continuous positive airway pressure\u2010intolerant OSA were included. The percentage of sleep time below SaO<jats:sub>2<\/jats:sub> 90% (pT90) was used to characterize oxygenation status. Wilcoxon signed\u2010rank test compared changes in sleep metrics from preoperatively to postoperatively. Linear regression was performed to assess whether changes in pT90 were correlated with changes in AHI and Epworth Sleepiness Scale (ESS), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 219 patients were included (65% HGNS, 24% ESP, 11% MMA). The average decline in AHI and ESS was 11.9 events\/h (standard deviation [SD]\u2009=\u200919.9, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) and 3.2 points (SD\u2009=\u20094.7, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), respectively. Among measures of sleep oxygenation, pT90 (11.5\u2009\u2192\u20098.9, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), oxygen desaturation index (27.1\u2009\u2192\u200915.1, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), and SpO<jats:sub>2<\/jats:sub> nadir (79.9\u2009\u2192\u200981.2, <jats:italic>P<\/jats:italic>\u2009=\u2009.03) improved significantly following surgery. On linear regression, changes in pT90 were significantly correlated with changes in AHI (<jats:italic>\u03b2<\/jats:italic>\u2009=\u20090.31, 95% confidence interval [CI] 0.18\u20100.45, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) and ESS (<jats:italic>\u03b2<\/jats:italic>\u2009=\u2009.05, 95% CI 0.00, 0.09, <jats:italic>P<\/jats:italic>\u2009=\u2009.038), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Upper airway surgery improves metrics of oxygen status in addition to the AHI. Changes in pT90 correlate with subjective symptoms of OSA per ESS, suggesting utility in capturing disease burden.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.1182","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T01:13:46Z","timestamp":1741742026000},"page":"1781-1788","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Changes in Hypoxemia Metrics After Upper Airway Surgery for Obstructive Sleep Apnea"],"prefix":"10.1002","volume":"172","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6428-2064","authenticated-orcid":false,"given":"Praneet C.","family":"Kaki","sequence":"first","affiliation":[{"name":"Sidney Kimmel Medical College Thomas Jefferson University Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer A.","family":"Goldfarb","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Medical College Thomas Jefferson University Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie P.","family":"Snyder","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Medical College Thomas Jefferson University Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elliott M.","family":"Sina","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Medical College Thomas Jefferson University Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas M.","family":"Kaffenberger","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin","family":"Creighton","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology and Sleep Medicine Thomas Jefferson University Hospital Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Molin","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology and Sleep Medicine Thomas Jefferson University Hospital Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurits","family":"Boon","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology and Sleep Medicine Thomas Jefferson University Hospital Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin","family":"Huntley","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology and Sleep Medicine Thomas Jefferson University Hospital Philadelphia Pennsylvania 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