{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T14:58:30Z","timestamp":1778338710092,"version":"3.51.4"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,1,29]],"date-time":"2023-01-29T00:00:00Z","timestamp":1674950400000},"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":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The increased risk of cardiovascular diseases owing to a high level of serum homocysteine has been widely reported. Literature has demonstrated that patients with obstructive sleep apnea\/hypopnea syndrome (OSA) had a higher homocysteine level than control group. This study aimed to investigate the alteration of serum homocysteine levels in severe OSA patients receiving transoral robotic surgery (TORS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary academic medical center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data of polysomnography (PSG) and serum homocysteine levels before and at least 3 months after the surgery were collected and analyzed via paired <jats:italic>t<\/jats:italic> tests. A subgroup analysis based on the preoperative homocysteine level (\u226515\u2009mcmol\/L, as hyperhomocysteinemia group) was conducted to compare the intergroup differences of homocysteine decrease. Pearson's correlation was used to survey the relationships between the changes of major PSG parameters and the levels of homocysteine decrease at baseline and after TORS\u2010OSA surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred sixty\u2010one\u00a0patients with severe OSA were enrolled. There were significant improvements in major PSG parameters after TORS\u2010OSA surgery. Homocysteine levels significantly decreased from 12.1\u2009\u00b1\u20093.9\u00a0to 11.4\u2009\u00b1\u20093.7 mcmol\/L (difference\u2009=\u2009\u22120.7\u2009\u00b1\u20092.8 mcmol\/L, <jats:italic>p<\/jats:italic>\u2009=\u2009.001) postoperatively, which was shown in the hyperhomocysteinemia group (difference\u2009=\u2009\u22122.9\u2009\u00b1\u20094.7\u2009mcmol\/L, <jats:italic>p<\/jats:italic>\u2009=\u2009.007) to a greater extent. Pearson's correlation revealed that \u0394ODI (oxygen desaturation index\/h) was the predominant estimate with a positive association with \u0394homocysteine (<jats:italic>r<\/jats:italic>\u2009=\u20090.525, <jats:italic>p<\/jats:italic>\u2009=\u2009.012).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>TORS\u2010OSA surgery could decrease homocysteine levels in OSA patients. The effects were more relevant in severe OSA patients with abnormal preoperative homocysteine levels.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.218","type":"journal-article","created":{"date-parts":[[2023,1,29]],"date-time":"2023-01-29T10:43:11Z","timestamp":1674988991000},"page":"1238-1244","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Homocysteine Levels in Severe OSA Patients Before and After TORS\u2010OSA Surgery"],"prefix":"10.1002","volume":"168","author":[{"given":"Li\u2010Wen","family":"Chiu","sequence":"first","affiliation":[{"name":"Department of Education Kaohsiung Chang Gung Memorial Hospital  Kaohsiung Taiwan"},{"name":"Department of Ophthalmology, Division of Glaucoma Kaohsiung Chang Gung Memorial Hospital  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chung\u2010Wei","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Education Kaohsiung Chang Gung Memorial Hospital  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pei\u2010Wen","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Division of Glaucoma Kaohsiung Chang Gung Memorial Hospital  Kaohsiung Taiwan"},{"name":"College of Medicine Chang Gung University  Taoyuan Taiwan"},{"name":"Sleep Center, Kaohsiung Chang Gung Memorial Hospital  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Han\u2010Tan","family":"Chai","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiology Kaohsiung Chang Gung Memorial Hospital  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun\u2010Tuan","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Business Management, Institute of Healthcare Management National Sun Yat\u2010sen University  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Friedman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology,\u00a0Division of Sleep Surgery Rush University Medical Center  Chicago Illinois USA"},{"name":"Department of Otolaryngology, Advanced Center for Specialty Care Advocate Illinois Masonic Medical Center  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna M.","family":"Salapatas","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Advanced Center for Specialty Care Advocate Illinois Masonic Medical Center  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8822-0619","authenticated-orcid":false,"given":"Hsin\u2010Ching","family":"Lin","sequence":"additional","affiliation":[{"name":"College of Medicine Chang Gung University  Taoyuan Taiwan"},{"name":"Sleep Center, Kaohsiung Chang Gung Memorial Hospital  Kaohsiung Taiwan"},{"name":"Department of Business Management, Institute of Healthcare Management National Sun Yat\u2010sen University  Kaohsiung Taiwan"},{"name":"Department of Otolaryngology, Robotic Surgery Center and Center for Quality Management Kaohsiung Chang Gung Memorial Hospital  Kaohsiung 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