{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T12:59:14Z","timestamp":1790773154146,"version":"4.1.0"},"reference-count":17,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n To investigate race\u2010based differences in upper\u2010airway collapse patterns during drug\u2010induced sleep endoscopy (DISE) and assess their potential contribution to disparities in hypoglossal nerve stimulation (HGNS) eligibility among black patients with obstructive sleep apnea (OSA).<\/jats:p>\n <\/jats:sec>\n \n Study Design<\/jats:title>\n Retrospective cohort study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Academic tertiary care center.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Adult patients with OSA who underwent DISE were included. Procedures were performed using a standardized propofol protocol and scored using the Velum, Oropharynx, Tongue base, Epiglottis (VOTE) classification. Patients self\u2010identifying as black or white were analyzed. Demographic, anthropometric, and polysomnographic data were compared using\n t<\/jats:italic>\n tests and chi\u2010squared analyses. Logistic regression was performed to determine whether race was independently associated with anterior\u2010posterior (AP) velum collapse after adjusting for covariates.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Ninety patients were analyzed (black: n\u2009=\u200920; white: n\u2009=\u200970). Groups were similar in age, sex, body mass index, apnea\u2010hypopnea index, and neck circumference. AP collapse was significantly less common among black than white patients (40% vs 71%,\n P<\/jats:italic>\n \u2009=\u2009.02). In multivariable modeling adjusting for age, sex, body mass index, neck circumference, and pharyngeal opening pressure, black race remained an independently negatively associated with AP collapse (odds ratio 0.09, 95% CI [0.02\u20100.40],\n P<\/jats:italic>\n \u2009<\u2009.01).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Black patients were significantly less likely than white patients to exhibit AP velum collapse on DISE, potentially limiting eligibility for HGNS therapy. These findings suggest that racial differences in upper\u2010airway physiology may contribute to disparities in access to surgical treatment for OSA and underscore the need for therapies addressing non\u2010AP collapse phenotypes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/ohn.70473","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T12:21:27Z","timestamp":1790770887000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Race\u2010Based Differences in Velopharyngeal Collapse Patterns During Drug\u2010Induced Sleep Endoscopy"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2349-387X","authenticated-orcid":false,"given":"Katherine P.","family":"Gouldman","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Emory University School of Medicine Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1660-2172","authenticated-orcid":false,"given":"Bailey L.","family":"Kane","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Emory University School of Medicine Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8009-5000","authenticated-orcid":false,"given":"Jason L.","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Emory University School of Medicine Atlanta Georgia 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