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International expert consensus statement: surgical failure in obstructive sleep apnea.
Iannella, Giannicola; Pace, Annalisa; Magliulo, Giuseppe; Vicini, Claudio; Lugo, Rodolfo; Vanderveken, Olivier M; de Vries, Nico; Pang, Kenny; Thuler, Eric; Jacobowitz, Ofer; Cahali, Michel Burihan; Maurer, Joachim T; Casale, Manuele; Moffa, Antonio; Salamanca, Fabrizio; Leone, Federico; Olszewska, Ewa; Reina, Carlos O'connor; Zancanella, Edilson; Hoff, Paul T; Baptista, Peter; Bahgat, Ahmed Yassin; Ravesloot, Madeline J L; van Maanen, Peter; Goldberg, Andrew; Carrasco, Marina; Agrawal, Vikas K; Lechien, Jerome R; De Vito, Andrea; Cammaroto, Giovanni; De Virgilio, Armando; Greco, Antonio; Mancini, Patrizia; Perrone, Tiziano; Amado, Steve; Alkan, Uri; Cheong, Ryan Chin Taw; D'Ecclesia, Aurelio; Galantai, Dorina; RajuAnand, Anand; Calvo-Henriquez, Christian; Cocuzza, Salvatore; Arigliani, Michele; Saibene, Alberto Maria; Aragona, Rosario Marchese; Maniaci, Antonino.
Affiliation
  • Iannella G; Department of 'Organi Di Senso', University "Sapienza", Viale Università 33, 00185, Rome, Italy. giannicola.iannella@uniroma1.it.
  • Pace A; Department of 'Organi Di Senso', University "Sapienza", Viale Università 33, 00185, Rome, Italy.
  • Magliulo G; Department of 'Organi Di Senso', University "Sapienza", Viale Università 33, 00185, Rome, Italy.
  • Vicini C; Department ENT & Audiology, University of Ferrara, Ferrara, Italy.
  • Lugo R; Department of Otorhinolaryngology, Grupo Medico San Pedro, 64660, Monterrey, Mexico.
  • Vanderveken OM; Faculty of Medicine and Health Sciences, Translational Neurosciences, University of Antwerp, Antwerp, Belgium.
  • de Vries N; Department of ENT, Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium.
  • Pang K; Multidisciplinary Sleep Disorders Centre, Antwerp University Hospital, Edegem, Belgium.
  • Thuler E; Department of Orofacial Pain and Dysfunction, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, The Netherlands.
  • Jacobowitz O; Asia Sleep Centre, Singapore, Singapore.
  • Cahali MB; Division of Sleep Surgery, Department of Otorhinolaryngology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
  • Maurer JT; Sleep Department, ENT and Allergy Associates, New York, NY, USA.
  • Casale M; Departamento de Otorrinolaringologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, SP, Brazil.
  • Moffa A; Division of Sleep Medicine, Department of Otorhinolaryngology, University Hospital Mannheim, Mannheim, Germany.
  • Salamanca F; Integrated Therapies in Otolaryngology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128, Rome, Italy.
  • Leone F; Integrated Therapies in Otolaryngology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128, Rome, Italy.
  • Olszewska E; Otorhinolaryngology Unit, San Pio X Hospital, 20159, Milan, Italy.
  • Reina CO; Otorhinolaryngology Unit, San Pio X Hospital, 20159, Milan, Italy.
  • Zancanella E; Department of Otolaryngology, Sleep Apnea Surgery Center, Medical University of Bialystok, 15-276, Bialystok, Poland.
  • Hoff PT; Otorhinolaryngology Department, Hospital Quironsalud Marbella, Marbella, Spain.
  • Baptista P; State University of Campinas, Campinas, São Paulo, Brazil.
  • Bahgat AY; Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI, USA.
  • Ravesloot MJL; Otorhinolaryngology Department, Clínica Universitaria de Navarra, Pamplona, Spain.
  • van Maanen P; Department of Otorhinolaryngology-Head & Neck Surgery, Alexandria University, Alexandria, 5424041, Egypt.
  • Goldberg A; Department of Otorhinolaryngology-Head and Neck Surgery, OLVG, Amsterdam, The Netherlands.
  • Carrasco M; Division of Rhinology and Sinus Surgery, Department of Otolaryngology, Head and Neck Surgery, University of California, 2233 Post Street, Room 309, San Francisco, CA, 94115-1225, USA.
  • Agrawal VK; Department of Otorhinolaryngology, Doctor Peset University Hospital, Valencia, Spain.
  • Lechien JR; Department of Otorhinolaryngology, Doctor Peset University Hospital, Valencia, Spain.
  • De Vito A; Speciality ENT Hospital, Thakur Complex, Kandivali (E), Mumbai, Maharashtra, 400101, India.
  • Cammaroto G; Division of Laryngology and Broncho-Esophagology, Department of Otolaryngology-Head Neck Surgery, EpiCURA Hospital, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.
  • De Virgilio A; Department of Otolaryngology-Head and Neck Surgery, Forli Hospital, Forli, Italy.
  • Greco A; Department of Otolaryngology-Head and Neck Surgery, Forli Hospital, Forli, Italy.
  • Mancini P; Department of 'Organi Di Senso', University "Sapienza", Viale Università 33, 00185, Rome, Italy.
  • Perrone T; Department of 'Organi Di Senso', University "Sapienza", Viale Università 33, 00185, Rome, Italy.
  • Amado S; Department of 'Organi Di Senso', University "Sapienza", Viale Università 33, 00185, Rome, Italy.
  • Alkan U; Otorhinolaryngology Unit, Civil Hospital of Alghero, Alghero, Italy.
  • Cheong RCT; Maple Respiratory, Universidad del Rosario, Bogotá, Colombia.
  • D'Ecclesia A; Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.
  • Galantai D; Royal National ENT and Eastman Dental Hospitals, University College London Hospitals NHS, London, UK.
  • RajuAnand A; IRCCS 'Casa Sollievo Della Sofferenza', San Giovanni Rotondo, Italy.
  • Calvo-Henriquez C; Department of Otorhinolaryngology, Head and Neck Surgery, Bajcsy-Zsilinszky Hospital, Budapest, Hungary.
  • Cocuzza S; Department of ENT Surgery, PSG Hospitals, Coimbatore, India.
  • Arigliani M; Rhinology and Sleep Apnea Unit, Otolaryngology Department, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain.
  • Saibene AM; Deparment of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia, University of Catania, 95123, Catania, Italy.
  • Aragona RM; Otolaryngology Unit, Vito Fazzi Hospital, Lecce, Italy.
  • Maniaci A; Otolaryngology Unit, Santi Paolo E Carlo Hospital, Department of Health Sciences, Università Degli Studi Di Milano, Milan, Italy.
Sleep Breath ; 2024 Sep 23.
Article in En | MEDLINE | ID: mdl-39307877
ABSTRACT

PURPOSE:

Upper airway (UA) surgery is commonly employed in the treatment of patients with obstructive sleep apnea (OSA). The intricate pathophysiology of OSA, variability in sites and patterns of UA collapse, and the interaction between anatomical and non-anatomical factors in individual patients may contribute to possible surgical failures. This clinical consensus statement aims to identify areas of agreement among a development group comprising international experts in OSA surgery, regarding the appropriate definition, predictive factors in patients, and management of surgical failure in OSA treatment.

METHODS:

A clinical consensus statement (CCS) was developed using the Delphi method by a panel of 35 contributors from various countries. A systematic literature review adhering to PRISMA guidelines was conducted. A survey consisting of 60 statements was then formulated and presented to the experts.

RESULTS:

Following two rounds of the Delphi process, consensus or strong consensus was achieved on 36 items, while 24 items remained without consensus. Specifically, 5 out of 10 statements reached consensus regarding on the 'Definition of Surgical Success/Failure after OSA Surgery'. Regarding the 'Predictive Factors of Surgical Failure in OSA Surgery', consensus was reached on 10 out of 13 statements. In the context of the 'Diagnostic Workup in OSA Surgery', consensus was achieved on 9 out of 13 statements. Lastly, in 'Treatment in Surgical Failure Cases', consensus was reached on 12 out of 24 statements.

CONCLUSION:

The management of OSA after surgical failure presents a significant clinical challenge for sleep specialists. This CCS provides valuable guidance for defining, preventing, and addressing surgical failures in the treatment of OSA syndrome.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Sleep Breath Year: 2024 Document type: Article
Fulltext
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XML
PubMed Links
Search on Google

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Sleep Breath Year: 2024 Document type: Article