{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T08:01:50Z","timestamp":1789027310532,"version":"build-2803163510"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T00:00:00Z","timestamp":1673222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to evaluate the predictive value of drug-induced sleep endoscopy (DISE) for the outcomes of velopharyngeal surgery in adult patients with Friedman stage II and III obstructive sleep apnea syndrome (OSAS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 39 male OSAS patients with Friedman stage II and III were retrospectively analyzed. Subjects with an apnea-hypopnea index (AHI) &amp;gt; 5 events\/h indicated by polysomnography (PSG) and typical symptoms, such as snoring, sleep apnea, and daytime sleepiness, were included in this study. All these patients underwent pre-operative DISE examinations and were treated by velopharyngeal surgery and evaluated by velum, oropharynx, tongue base, and epiglottis (VOTE) scoring system. Clinical, polysomnographic parameters (e.g., hypopnea, apnea, AHI, lowest oxygen saturation, etc.), cephalometric variables, and DISE findings were evaluated. The treatment outcomes were assessed by polysomnography at least 6 months after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All 39 patients showed complete velopharyngeal airway collapses during pre-operative DISE examinations. After surgery, the AHI was significantly improved from 50.2 \u00b1 21.6 to 19.8 \u00b1 19 events\/h (<jats:italic>P<\/jats:italic> &amp;lt; 0.05). There were 23 responders (59.0%) and 16 non-responders (41.0%). The glossopharyngeal airway collapse degree (GA-CD) was significantly different between responders and non-responders (<jats:italic>P<\/jats:italic> &amp;lt; 0.05). The velopharyngeal airway collapse pattern (VA-CP) and GA-CD were independently predictive of treatment outcomes (both <jats:italic>P<\/jats:italic> &amp;lt; 0.05). Patients with non-lateral VA-CP and grade II GA-CD (collapse degree &amp;gt; 50%) had a significantly lower surgical success rate than those without (<jats:italic>P<\/jats:italic> &amp;lt; 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The VA-CP and GA-CD in DISE examination are valuable for predicting the treatment outcomes of velopharyngeal surgery in patients with Friedman stage II and III OSAS. Patients with lateral VA-CP and grade I GA-CD are appropriate candidates for velopharyngeal surgery.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2022.1049425","type":"journal-article","created":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T21:51:20Z","timestamp":1673387480000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Application of drug-induced sleep endoscopy in predicting the outcomes of velopharyngeal surgery in adult patients with Friedman stage II and III obstructive sleep apnea syndrome"],"prefix":"10.3389","volume":"13","author":[{"given":"Xin","family":"Cao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingqian","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junbo","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoping","family":"Yin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingying","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,1,9]]},"reference":[{"key":"B1","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1016\/B0-72-160797-7\/50094-X","article-title":"Clinical features and evaluation of obstructive sleep apnea-hypopnea syndrome and upper airway resistance syndrome","volume-title":"Principles And Practice Of Sleep Med- icine","author":"Guilleminault","year":"2005"},{"key":"B2","doi-asserted-by":"publisher","first-page":"263","DOI":"10.5664\/jcsm.27497","article-title":"Clinical guideline for the evaluation, management and long-term care of obstruc- tive sleep apnea in adults","volume":"5","author":"Epstein","year":"2009","journal-title":"J Clin Sleep Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1093\/sleep\/29.3.375","article-title":"Practice parameters for the use of continuous and bilevel pos- itive airway pressure devices to treat adult patients with sleep-related breathing disorders","volume":"29","author":"Kapur","year":"2006","journal-title":"Sleep."},{"key":"B4","doi-asserted-by":"publisher","first-page":"829","DOI":"10.1136\/thx.2010.135848","article-title":"Predictors of long-term compliance with continuous positive airway pressure","volume":"65","author":"Kohler","year":"2010","journal-title":"Thorax"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1647","DOI":"10.5665\/sleep.3118","article-title":"Increasing adherence to obstructive sleep apnea treatment with a group social cognitive therapy treatment intervention: a randomized trial","volume":"36","author":"Bartlett","year":"2013","journal-title":"Sleep"},{"key":"B6","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1159\/000087390","article-title":"Revised uvulopalatopharyngoplasty with uvula preservation and its clinical study","volume":"67","author":"Han","year":"2005","journal-title":"ORL J Otorhinolaryngol Relat Spec"},{"key":"B7","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1016\/j.otot.2009.01.003","article-title":"Combination of trans- palatal advancement pharyngoplasty and H-uvulopalatopharyn- goplasty for obstructive sleep apnea","volume":"20","author":"Jingying","year":"2009","journal-title":"Operat Techn Otolaryngol Head Neck Surg"},{"key":"B8","doi-asserted-by":"publisher","first-page":"904","DOI":"10.1177\/0194599816661481","article-title":"Predicting outcomes after uvulopalatopharyngoplasty for adult obstructive sleep apnea: a meta-analysis","volume":"155","author":"Choi","year":"2016","journal-title":"Otolaryngol Head Neck Surg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1177\/0194599815576719","article-title":"The role of obstruction length and height in predicting outcome of velopharyngeal surgery","volume":"153","author":"Zhang","year":"2015","journal-title":"Otolaryngol Head Neck Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1097\/00005537-200403000-00013","article-title":"staging of obstructive sleep apnea\/hypopnea syndrome: a guide to appropriate treatment","volume":"114","author":"Friedman","year":"2004","journal-title":"Laryngoscope"},{"key":"B11","doi-asserted-by":"publisher","first-page":"597","DOI":"10.5664\/jcsm.2172","article-title":"Rules for scoring respiratory events in sleep: update of the 2007 AASM manual for the scoring of sleep and associated events. 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