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Sleep Medicine

Palate Shape Is Associated With Pharyngeal Surgical Outcomes

Monday, October 2, 2023
8:30 AM - 8:36 AM East Coast USA Time
Location: 103A

    Presenting Author(s)

  • Emily A. Commesso, MD

    Assistant Professor
    Dept Head and Neck Surgery & Communication Sciences, Duke University School of Medicine
    Durham, NC, United States

    • Senior Author(s)

  • Eric James Kezirian, MD, MPH

    Professor, Head and Neck Surgery
    David Geffen School of Medicine at UCLA
    Santa Monica, CA, United States

    • Co-Author(s)

  • Abhay V. Sharma, MD

    Assistant Professor
    University of South Florida Morsani College of Medicine
    Tampa, FL, United States

  • B Tucker Woodson, MD

    Professor and Chief
    Medical College of Wisconsin
    Milwaukee, WI, USA

  • Suraj Kedarisetty, MD

    Resident
    Temple University Hospital
    Fremont, California, United States

Disclosure(s):
Emily A. Commesso, MD: No relevant relationships to disclose.
Eric James Kezirian, MD, MPH: No relevant relationships to disclose.
Abhay V. Sharma, MD: No relevant relationships to disclose.
Introduction: Pharyngeal surgery is a common surgical approach for patients with obstructive sleep apnea (OSA) unable to tolerate positive pressure therapy. This study aims to determine the association between palate shape as described by Woodson and pharyngeal surgical outcomes.

Methods: This retrospective multicenter cohort study included study participants who underwent preoperative drug-induced sleep endoscopy (DISE) and pharyngeal surgery. Three blinded reviewers examined the DISE videos to assess palate shape, with consensus scores developed using a priori criteria. Palate shape scores were examined for an association with surgical outcomes with univariate analyses and multiple regression.

Results: Among 275 study participants from 14 centers, age was 51.4 ± 11.8 years, body mass index was 30.1 ± 5.2 kg/m2, and 19% were female. Preliminary analyses indicate that hard palate score of 3 (most narrow) was associated with a lower odds of surgical response, before and after adjustment for age, gender, body mass index, type of surgery, and key DISE findings related to the oropharyngeal lateral walls and tongue (p < 0.05). Other palate shape scores were not consistently associated with surgical outcomes.

Conclusions: Narrowing at the hard palate was independently associated with lower odds of response to pharyngeal surgery.