{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T13:37:12Z","timestamp":1785332232757,"version":"3.55.0"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["NRF\u20102021R1A2C2010811"],"award-info":[{"award-number":["NRF\u20102021R1A2C2010811"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Surgical outcomes after upper\u2010airway surgery for obstructive sleep apnea vary widely because of clinical heterogeneity. This study aimed to identify distinct obstructive sleep apnea phenotypes using unsupervised clustering and evaluate their association with surgical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective prognostic cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Single\u2010centre study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Two hundred fourteen adults who underwent upper\u2010airway surgery for obstructive sleep apnea were analysed across 50 clinical and polysomnographic variables. The Leiden clustering algorithm was used to identify patient subgroups. Baseline characteristics and surgical outcomes, including changes in the apnea\u2010hypopnea index and oxygen saturation, were compared across the identified clusters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The analysis revealed 3 distinct patient phenotypes. Cluster 0 (n\u2009=\u200991) comprised older patients with lower BMI and a high frequency of respiratory effort\u2010related arousal. Cluster 1 (n\u2009=\u200973) was characterised by younger patients with higher BMI and severe apnea\u2010dominant obstructive sleep apnea. Cluster 2 (n\u2009=\u200950) was defined by significant anatomical obstruction and hypopnea\u2010dominant breathing patterns. The reductions in the apnea\u2010hypopnea index and oxygen desaturation index were significantly less pronounced in Cluster 0 than in Clusters 1 and 2 (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.01). Conversely, Cluster 1 showed the greatest improvement, with a significantly larger reduction in the apnea index and a greater increase in the lowest oxygen saturation compared to the other 2 clusters (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Unsupervised clustering of multidimensional data revealed obstructive sleep apnea phenotypes with distinct surgical prognoses. Integrating this approach into preoperative evaluations may help inform surgical counseling and shared decision\u2010making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70165","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T13:34:08Z","timestamp":1770384848000},"page":"1091-1101","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Unsupervised Phenotyping to Stratify Surgical Outcomes in Obstructive Sleep Apnea"],"prefix":"10.1002","volume":"174","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5196-8482","authenticated-orcid":false,"given":"Dachan","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology Yonsei University College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung J.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Plastic and 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