{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T04:05:08Z","timestamp":1783915508167,"version":"3.55.0"},"reference-count":50,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    This study investigates the newly developed pharyngeal resistance index derived from computational fluid dynamics analysis of the upper airway in patients with obstructive sleep apnea. The aim was to evaluate this index as a diagnostic and severity assessment tool by comparing it with the apnea\u2010hypopnea index before and after maxillomandibular advancement surgery. A retrospective single\u2010center study was conducted at the Department of Oral and Maxillofacial Surgery, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, including 16 patients with obstructive sleep apnea who underwent maxillomandibular advancement between November 2019 and June 2023. Each patient received polysomnography and cone beam computed tomography preoperatively and at least three months postoperatively following a standardised protocol. The apnea\u2010hypopnea index and pharyngeal resistance index were statistically compared. The mean apnea\u2010hypopnea index decreased from 23.42 (SD\u2009=\u200922.53) preoperatively to 4.32 (SD\u2009=\u20095.0) postoperatively, a mean reduction of 81.55%. Mean pharyngeal resistance index decreased from 0.96 (SD\u2009=\u20090.81) preoperatively to 0.17 (SD\u2009=\u20090.22) postoperatively, representing an 82.29% reduction. Wilcoxon signed\u2010rank tests confirmed significant postoperative improvements for both indices (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01). Spearman analysis revealed no significant correlation between both indices, either preoperatively (\u03c1\u2009=\u20090.130,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.633) or postoperatively (\u03c1\u2009=\u20090.159,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.556). Class\u2010based comparison demonstrated improved agreement postoperatively, with most discrepancies limited to within \u00b11 class. Although no direct correlation was found, the pharyngeal resistance index demonstrated significant postoperative improvement and enhanced class\u2010level agreement with the apnea\u2010hypopnea index, supporting its future role as a supplementary diagnostic and predictive tool in obstructive sleep apnea management.\n                  <\/jats:p>","DOI":"10.1111\/jsr.70341","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T02:20:53Z","timestamp":1776133253000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Pharyngeal Resistance Index\u2014A Promising Diagnostic Tool in\n                    <scp>OSA<\/scp>"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7060-5187","authenticated-orcid":false,"given":"Nils Lucca","family":"Kern","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t Zu Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Pugachev","sequence":"additional","affiliation":[{"name":"Simq GmbH  Grafing bei M\u00fcnchen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Ebker","sequence":"additional","affiliation":[{"name":"MKG am Kaiserdamm  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim Lukas","family":"Elter","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t Zu Berlin  Berlin 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and Humboldt\u2010Universit\u00e4t Zu Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Bigus","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t Zu Berlin  Berlin 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