{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T23:20:22Z","timestamp":1778800822834,"version":"3.51.4"},"reference-count":14,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Otolaryngology - Head &amp; Neck Surgery"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective.<\/jats:title>\n                    <jats:p>\n                      A new critical complication risk analysis, the reasonable risk ratio (RRR or R\n                      <jats:sup>3<\/jats:sup>\n                      ) for palate surgeries in obstructive sleep apnea patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods.<\/jats:title>\n                    <jats:p>Analysis from published meta-analyses, systematic reviews on success rates, and complications encountered for 3 palate surgeries, expansion sphincter pharyngoplasty (ESP), barbed repositioning pharyngoplasty (BRP) and modified uvulopalatopharyngoplasty (mUPPP), over 20\u2009years. The RRR is derived from a ratio of the percentage of each respective complication over the success rate of that particular surgical procedure. The benchmark RRR of tonsillectomy is set at 0.035 to 0.078. An RRR below this benchmark value is more favorable as tonsillectomy is a widely accepted ENT procedure with risks to benefit well accepted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results.<\/jats:title>\n                    <jats:p>The RRR for foreign body (FB) sensation (BRP) ranged from 0.03 to 0.23 (mean RRR of 0.14), FB sensation (ESP) 0.01, FB sensation (mUPPP) ranged from 0.33 to 0.55 (mean RRR of 0.44). The RRR for swallowing difficulties (BRP) ranged from 0.04 to 0.23 (mean RRR of 0.11), mUPPP, was 0.37; no reported swallowing difficulties with the ESP. The RRR for velopharyngeal insufficiency (VPI) (BRP) ranged from 0.009 to 0.18 (mean RRR of 0.07), and RRR VPI (mUPPP) was 0.14. The RRR (BRP) for dry throat was 0.06 and the mUPPP was 0.35, with no reported VPI or dry throat for ESP. The overall RRR for the BRP was 0.09, ESP was 0.01 and mUPPP was 0.29.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion.<\/jats:title>\n                    <jats:p>RRR provides a summarized data-driven, statistical guide to aid decision-making, and helps in patient counseling. BRP and ESP have been shown to have less complications compared to mUPPP. Level of evidence: IV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19160216241279074","type":"journal-article","created":{"date-parts":[[2024,9,17]],"date-time":"2024-09-17T13:13:40Z","timestamp":1726578820000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Reasonable Risk Ratio of Palate Surgery: A New Critical Analysis"],"prefix":"10.1177","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3799-1891","authenticated-orcid":false,"given":"Kenny P.","family":"Pang","sequence":"first","affiliation":[{"name":"Otolaryngology, Asia Sleep Centre, Paragon, Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joon","family":"Wei Lim","sequence":"additional","affiliation":[{"name":"General Surgery, Tan Tock Seng Hospital, Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen A.","family":"Pang","sequence":"additional","affiliation":[{"name":"Medicine Faculty, National University Singapore, Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"Vicini","sequence":"additional","affiliation":[{"name":"GB Morgagni-L Pierantoni Hospital, University of Ferrara and Bologna in Forli, Forli, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filippo","family":"Montevecchi","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Forli Private Hospitals, Forli, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan C.T.","family":"Cheong","sequence":"additional","affiliation":[{"name":"Otolaryngology, Royal National ENT Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward B.","family":"Pang","sequence":"additional","affiliation":[{"name":"Medicine Faculty, University of Glasgow, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin Keat","family":"Siow","sequence":"additional","affiliation":[{"name":"Otolaryngology Head and Neck Surgery, National University Singapore, Nanyang Technological University, Tan Tock Seng Hospital, Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiong","family":"Huak Chan","sequence":"additional","affiliation":[{"name":"Biostatistics Unit, School of Medicine, National University Singapore, Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Rotenberg","sequence":"additional","affiliation":[{"name":"Otolaryngology, Western University, London, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,9,17]]},"reference":[{"key":"bibr1-19160216241279074","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2016.12.003"},{"key":"bibr2-19160216241279074","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.127.10.1271"},{"key":"bibr3-19160216241279074","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2007.03.014"},{"key":"bibr4-19160216241279074","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23911"},{"key":"bibr5-19160216241279074","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-015-3628-3"},{"key":"bibr6-19160216241279074","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0709(03)00047-4"},{"key":"bibr7-19160216241279074","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29357"},{"key":"bibr8-19160216241279074","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2021.103306"},{"key":"bibr9-19160216241279074","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17051542"},{"key":"bibr10-19160216241279074","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-022-02585-3"},{"key":"bibr11-19160216241279074","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28432"},{"key":"bibr12-19160216241279074","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-023-07901-5"},{"key":"bibr13-19160216241279074","doi-asserted-by":"publisher","DOI":"10.1177\/0194599819840356"},{"key":"bibr14-19160216241279074","doi-asserted-by":"publisher","DOI":"10.1177\/0194599816688646"}],"container-title":["Journal of Otolaryngology - Head &amp; 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