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ACS stabilises the pharynx by pulling it caudally, but its specific effects on flow limitation caused by palatal, oropharyngeal lateral wall, tongue base, or epiglottis collapse remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To quantify the effect of ACS on collapsibility of different pharyngeal flow-limiting structures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participants with OSA underwent bilateral ACS during drug-induced sleep endoscopy. Maximum inspiratory airflow was assessed over a range of positive airway pressures while ACS was applied. The flow-limiting structure for each breath was classified based on manometric and endoscopic findings and a linear mixed-effects model characterised their response to ACS. The influence of patient characteristics was explored with univariate models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and main results<\/jats:title>\n                    <jats:p>\n                      41 participants yielded 1761 breaths for analysis. On average, bilateral ACS decreased the observed pharyngeal critical closing (\n                      <jats:italic>P<\/jats:italic>\n                      <jats:sub>CRIT<\/jats:sub>\n                      ) and opening (\n                      <jats:italic>P<\/jats:italic>\n                      <jats:sub>OPEN<\/jats:sub>\n                      ) pressures by \u22123.0 (95% CI \u22123.6\u2013\u22122.3) and \u22123.7 (\u22124.4\u2013\u22123.0) cmH\n                      <jats:sub>2<\/jats:sub>\n                      O, respectively (p&lt;0.001). During tongue base obstruction, modelled ACS effects for\n                      <jats:italic>P<\/jats:italic>\n                      <jats:sub>CRIT<\/jats:sub>\n                      and\n                      <jats:italic>P<\/jats:italic>\n                      <jats:sub>OPEN<\/jats:sub>\n                      were \u22122.0 (\u22122.7\u2013\u22121.4) and \u22123.1 (\u22123.8\u2013\u22122.4) cmH\n                      <jats:sub>2<\/jats:sub>\n                      O, respectively (p&lt;0.001). Greater reductions were generally observed for other flow-limiting structures. A lower apnoea\u2013hypopnea index was associated with a greater decrease in\n                      <jats:italic>P<\/jats:italic>\n                      <jats:sub>OPEN<\/jats:sub>\n                      (p&lt;0.01). Other patient characteristics, including body mass index, did not influence\n                      <jats:italic>P<\/jats:italic>\n                      <jats:sub>CRIT<\/jats:sub>\n                      or\n                      <jats:italic>P<\/jats:italic>\n                      <jats:sub>OPEN<\/jats:sub>\n                      (p&gt;0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Bilateral ACS decreased collapsibility of all airway flow-limiting structures. ACS generally had greater effects on palatal, oropharyngeal lateral wall and epiglottic collapse than the tongue base.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1183\/13993003.00901-2024","type":"journal-article","created":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T11:25:17Z","timestamp":1728905117000},"page":"2400901","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":21,"title":["Ansa cervicalis stimulation effects on upper airway patency: a structure-based analysis"],"prefix":"10.1183","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8465-130X","authenticated-orcid":false,"given":"Yike","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9222-3751","authenticated-orcid":false,"given":"Alan 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