{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T22:19:57Z","timestamp":1776723597943,"version":"3.51.2"},"reference-count":9,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,3,21]],"date-time":"2017-03-21T00:00:00Z","timestamp":1490054400000},"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":[[2017,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Recent evidence suggests that multilevel sleep surgery improves outcomes when compared with palate surgery alone for most patients. The study objective was to compare demographic and outcomes data for palate surgery (uvulopalatopharyngoplasty [UPPP]) alone versus multilevel surgery through a national insurance claims database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>National insurance claims database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>An adult cohort undergoing single\u2010level UPPP versus UPPP with nasal and\/or tongue\/hypopharyngeal surgery was identified in the Truven Health Analytics MarketScan Research Databases for the years 2010 through 2012. Demographic and outcomes data were assessed at short\u2010term (\u226414\u00a0days), intermediate (15\u201060\u00a0days), and long\u2010term (61\u2010183\u00a0days) intervals via a multivariate regression model adjusted for age, sex, geographic region, insurance type, and the Charlson\u2010Deyo comorbidity score. The primary long\u2010term complication considered was positive airway pressure (PAP) equipment supply, implying possible treatment failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The cohort included 14,633 patients: 7559 (51.6%), UPPP alone; 5219 (35.7%), UPPP + nasal surgery; 1164 (7.95%), UPPP + tongue\/hypopharyngeal surgery; and 691 (4.7%), UPPP + nasal + tongue\/hypopharyngeal surgery. Demographic data were similar among the groups. UPPP alone had lower rates of postoperative bleeding than UPPP + tongue\/hypopharyngeal surgery (4.31% vs 6.19%, <jats:italic>P<\/jats:italic> =. 004). Multivariate modeling indicated that the addition of either nasal surgery (odds ratio = 1.21, 95% CI = 1.10\u20101.34, <jats:italic>P<\/jats:italic> &lt;. 001) or tongue\/hypopharyngeal surgery (odds ratio = 1.15, 95% CI = 1.00\u20101.32, <jats:italic>P<\/jats:italic> =. 048) to UPPP was associated with increased odds of postoperative continuous positive airway pressure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>UPPP alone is currently the predominant form of sleep surgery in the United States. Multilevel surgery had greater odds of postoperative bleeding and positive airway pressure equipment supply than UPPP alone. Dedicated studies formally evaluating single\u2010 versus multilevel sleep surgery and the impact of possible surgeon\/patient selection bias should be a priority.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599817696503","type":"journal-article","created":{"date-parts":[[2017,3,21]],"date-time":"2017-03-21T09:04:23Z","timestamp":1490087063000},"page":"955-961","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["National Database Analysis of Single\u2010Level versus Multilevel Sleep Surgery"],"prefix":"10.1002","volume":"156","author":[{"given":"Scott E.","family":"Brietzke","sequence":"first","affiliation":[{"name":"Walter Reed National Military Medical Center Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stacey L.","family":"Ishman","sequence":"additional","affiliation":[{"name":"Cincinnati Children\u2019s Hospital Medical Center and University of Cincinnati Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seth","family":"Cohen","sequence":"additional","affiliation":[{"name":"Duke University Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Derek D.","family":"Cyr","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer J.","family":"Shin","sequence":"additional","affiliation":[{"name":"Massachusetts Eye and Ear Infirmary Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric J.","family":"Kezirian","sequence":"additional","affiliation":[{"name":"University of Southern California Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,3,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/19.2.156"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2007.03.014"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2004.06.103"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812453000"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e31816422ea"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24325"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24346"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599816639038"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599817696503","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/0194599817696503","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599817696503","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:21:00Z","timestamp":1760955660000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0194599817696503"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3,21]]},"references-count":9,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2017,5]]}},"alternative-id":["10.1177\/0194599817696503"],"URL":"https:\/\/doi.org\/10.1177\/0194599817696503","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3,21]]},"assertion":[{"value":"2016-09-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-02-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-03-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}