{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:06:26Z","timestamp":1793383586116,"version":"4.5.0"},"reference-count":12,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2012,6,29]],"date-time":"2012-06-29T00:00:00Z","timestamp":1340928000000},"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":[[2012,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To characterize factors that surgeons perceive as affecting selection of procedures designed to treat hypopharyngeal obstruction in adults with obstructive sleep apnea (OSA) and to compare those factors among 2\u00a0groups of American Academy of Otolaryngology\u2014Head and Neck Surgery (AAO\u2010HNS) member surgeons.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Cross\u2010sectional online survey.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>AAO\u2010HNS members with a self\u2010identified subspecialty interest either in sleep medicine or general otolaryngology were asked to complete an online survey, each respondent rated (5\u2010point Likert scale) the perceived quality of their education and training and the role of specific factors in selection, both for procedure categories (eg, all hypopharyngeal) and individual procedures. Responses were examined for the entire group and for subgroups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Response rate was 27% (163\/610). Sixty\u2010five percent of respondents rated their surgical OSA education and training during postgraduate continuing medical education (CME) courses as of high quality, compared with 39% for residency\/fellowship and 4% for medical school (<jats:italic>P<\/jats:italic> &lt; 0.01). For individual hypopharyngeal procedures, over 40% of respondents reported limited training (except for tongue radiofrequency), and over 30% raised concerns about scientific evidence and reimbursement. Surgeon personal experience suggested treatment benefits without clearly favoring individual procedures. Respondents noted that patients were reluctant to undergo procedures, despite treatment recommendations, particularly maxillomandibular advancement. The sleep medicine subgroup reported higher ratings for education and training quality, research evidence, and personal experience with hypopharyngeal procedures. Concerns about adequate education and training, the quality of research evidence, and reimbursement issues were major factors in procedure selection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Multiple factors affect procedure selection. Surgeons identify concerns regarding education and training and research evidence.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599812453000","type":"journal-article","created":{"date-parts":[[2012,6,30]],"date-time":"2012-06-30T20:14:10Z","timestamp":1341087250000},"page":"964-971","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Hypopharyngeal Surgery in Obstructive Sleep Apnea"],"prefix":"10.1002","volume":"147","author":[{"given":"Eric J.","family":"Kezirian","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California San Francisco San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather M.","family":"Hussey","sequence":"additional","affiliation":[{"name":"American Academy of Otolaryngology\u2013Head and Neck Surgery Foundation Alexandria Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott E.","family":"Brietzke","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Walter Reed National Military Medical Center Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth M.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2013Head &amp; Neck Surgery Duke University Medical Center Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg E.","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Washington Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer J.","family":"Shin","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra G.","family":"Weinberger","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Texas Southwestern Medical Center Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Cabana","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Epidemiology &amp; Biostatistics Philip R. Lee Institute for Health Policy University of California San Francisco San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,6,29]]},"reference":[{"key":"e_1_2_8_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200403000-00013"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2010.26"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.22344"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.132.2.206"},{"key":"e_1_2_8_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2010.05.009"},{"key":"e_1_2_8_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/0194599811416765"},{"key":"e_1_2_8_8_2","volume-title":"Evidence\u2010Based Medicine: How to Practice and Teach EBM","author":"Sackett DL","year":"2000"},{"key":"e_1_2_8_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/33.10.1396"},{"key":"e_1_2_8_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.MR000008.pub4"},{"key":"e_1_2_8_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-200207000-00006"},{"key":"e_1_2_8_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/0163278707307899"},{"key":"e_1_2_8_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2009.10.018"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599812453000","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/0194599812453000","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599812453000","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T11:34:59Z","timestamp":1760960099000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0194599812453000"}},"subtitle":["Practice Patterns, Perceptions, and Attitudes"],"short-title":[],"issued":{"date-parts":[[2012,6,29]]},"references-count":12,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2012,11]]}},"alternative-id":["10.1177\/0194599812453000"],"URL":"https:\/\/doi.org\/10.1177\/0194599812453000","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,6,29]]},"assertion":[{"value":"2012-03-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-06-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-06-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}