{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:07:08Z","timestamp":1793383628304,"version":"4.5.0"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[1994,7,1]],"date-time":"1994-07-01T00:00:00Z","timestamp":773020800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[1994,7]]},"abstract":"<jats:p>The most widely reported surgical procedure for obstructive sleep apnea syndrome is uvulopalatopharyngoplasty. The success rate for this procedure is variable, and the reason for failure is incompletely understood. Failure in some patients is postulated to result from tongue\u2010base obstruction. To investigate this, we identified the level of collapse and obstruction in 11 cases of uvulopalatopharyngoplasty failure, using upper airway manometry and videoendoscopy, while patients slept. Airway manometry measured the initial level of complete obstruction. Videoendoscopy identified significant resting airway narrowing (&gt; 75%) at the tongue base on obstructed compared with nonobstructed breaths. Results of manometry indicated that the palate was the primary level of obstruction in eight (73%) compared with the tongue base in three (27%). However, collapse on videoendoscopy at the tongue base was observed in an additional three patients. A total of six patients (54%) demonstrated significant tongue\u2010base abnormalities. In six patients with uvulopalatopharyngoplasty as the only pharyngeal surgery, one (17%) had an obstruction at the tongue base, as measured with manometry. Three of the six also had collapses at the tongue base, as measured endoscopically. Tongue\u2010base abnormalities were identified in four of six (67%). Two additional patients who had failed uvulopalatopharyngoplasty and franspalatal advancement pharyngoplasty had obstructions on manometry at the level of tongue base. Six of eight (75%) palatopharyngoplasty failures demonstrated tongue\u2010base collapse. In the three patients with tongue\u2010base surgery, all had obstructions on manometry at the palate and none had endoscopic tongue\u2010base collapse. These results indicate that in most uvulopalatopharyngoplasty failures the initial level of obstruction occurs at the palate. However, tongue\u2010base collapse is frequent, and the associated increases in upper airway resistance, changes in ventilation, airflow limitatioins, and changes in airway reflexes may contribute to persistent apnea through complex mechanisms. Both obstructed and nonobstructed upper airway segments must be included in a model for surgical failures.<\/jats:p>","DOI":"10.1177\/019459989411100109","type":"journal-article","created":{"date-parts":[[2015,11,25]],"date-time":"2015-11-25T06:53:21Z","timestamp":1448434401000},"page":"38-43","source":"Crossref","is-referenced-by-count":65,"title":["Manometric and Endoscopic Localization of Airway Obstruction after Uvulopalatopharyngoplasty"],"prefix":"10.1002","volume":"111","author":[{"given":"B. Tucker","family":"Woodson","sequence":"first","affiliation":[{"name":"Department of Otolaryngology and Human Communication Medical College of Wisconsin Zablocki Veterans Administration Hospital Milwaukee Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marvin R.","family":"Wooten","sequence":"additional","affiliation":[{"name":"Department of Neurology Columbia Hospital Milwaukee Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[1994,7]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-199206000-00003"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.266.10.1384"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/136.3.755"},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/019459988509300222"},{"key":"e_1_2_1_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/019459988910100309"},{"key":"e_1_2_1_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/019459989210700107"},{"key":"e_1_2_1_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/019459988609400110"},{"key":"e_1_2_1_9_1","first-page":"39","article-title":"Obstructive sleep apnea in Treacher\u2010Collins syndrome","volume":"18","author":"Johnston C","year":"1981","journal-title":"Cleft Palate J"},{"key":"e_1_2_1_10_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/141.5_Pt_1.1350"},{"key":"e_1_2_1_11_1","volume-title":"The role of dynamic cephalometry in upper airway evaluation of obstructive sleep apnea syndrome","author":"Okamato M","year":"1991"},{"key":"e_1_2_1_12_1","first-page":"273","article-title":"Fast\u2010CT evaluation of the upper airway during wakefulness in patients with obstructive sleep apnea","volume":"345","author":"Shepard JW","year":"1990","journal-title":"Prog Clin Biol Res"},{"key":"e_1_2_1_13_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/143.5_Pt_1.942"},{"key":"e_1_2_1_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/019459989210700507"},{"key":"e_1_2_1_15_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-199110000-00013"},{"key":"e_1_2_1_16_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/138.6.1542"},{"key":"e_1_2_1_17_1","first-page":"211","article-title":"Pharyngeal compliance in snoring subjects with and without obstructive sleep apnea","volume":"132","author":"Brown IG","year":"1985","journal-title":"Am Rev Respir Dis"},{"key":"e_1_2_1_18_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.99.1.40"},{"key":"e_1_2_1_19_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1991.70.1.158"},{"key":"e_1_2_1_20_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1992.72.6.2128"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/019459989411100109","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/019459989411100109","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:23:24Z","timestamp":1760955804000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/019459989411100109"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1994,7]]},"references-count":19,"journal-issue":{"issue":"1","published-print":{"date-parts":[[1994,7]]}},"alternative-id":["10.1177\/019459989411100109"],"URL":"https:\/\/doi.org\/10.1177\/019459989411100109","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[1994,7]]}}}