{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T09:36:01Z","timestamp":1764322561785,"version":"3.46.0"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T00:00:00Z","timestamp":1756771200000},"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":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine drug\u2010induced sleep endoscopy (DISE) findings in individuals with persistent obstructive sleep apnea (OSA) after maxillomandibular advancement (MMA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Cross\u2010sectional.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Academic medical center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>DISE using propofol for unconscious sedation was performed in adult study participants with OSA after MMA and possible other procedures, defined by a postoperative apnea\u2010hypopnea index\u2009\u2265\u20095 events\/h. The pattern of obstruction during DISE in the supine body position was characterized using the VOTE Classification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty\u2010four study participants underwent DISE examinations. Age was 46.4\u2009\u00b1\u200910.5 years, and 12% (3\/24) were female. Body mass index was 26.4\u2009\u00b1\u20094.7\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      . DISE examinations were performed 889\u2009\u00b1\u20091009 days after MMA. The post\u2010MMA apnea\u2010hypopnea index was 18.2\u2009\u00b1\u200911.3 events\/h. During DISE, most study participants demonstrated tongue\u2010related obstruction, with a substantial minority showing velum\u2010 and epiglottis\u2010related obstruction. Oropharyngeal lateral wall\u2010related obstruction was less common. Compared to a larger cohort (n\u2009=\u2009810) with no previous pharyngeal OSA surgery undergoing DISE, velum\u2010 and oropharyngeal lateral wall\u2010related obstruction were less common, and epiglottis\u2010related obstruction was more common.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among individuals with OSA following MMA, upper airway obstruction occurs due to multiple potential anatomic structures. Tongue\u2010related obstruction is common, and epiglottis\u2010related obstruction is more common than in those without previous pharyngeal OSA surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70007","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T11:42:56Z","timestamp":1756813376000},"page":"1494-1499","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Persistent OSA After Maxillomandibular Advancement: Insights From Drug\u2010Induced Sleep Endoscopy"],"prefix":"10.1002","volume":"173","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3808-4521","authenticated-orcid":false,"given":"Eric James","family":"Kezirian","sequence":"first","affiliation":[{"name":"Department of Head and Neck Surgery University of California, Los Angeles Los Angeles California 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