The last thing anyone wants is to undergo surgery without achieving results. This idea has been the focus of my career in sleep surgery. It has been wonderful to contribute to advancing our understanding about the physical causes of obstructive sleep apnea and ways we can optimize our preoperative evaluation to select procedures. This work… Read more »

As a Fellow of the American College of Surgeons, I receive electronic access to the Journal of the American College of Surgeons. I browse the Table of Contents but generally find that most of the articles are related to general surgery or subspecialties within that field (which used to be true for head and neck… Read more »

We have just completed the 29th Advances in Diagnosis and Treatment of Sleep Apnea and Snoring course in San Francisco. It is so enjoyable to be one of the course directors, where we can think about the newest developments in the field and other topics to incorporate as we develop the program. As I do… Read more »

The Upper Airway Stimulation system from Inspire Medical Systems has been an important and exciting addition to the array of treatment options for obstructive sleep apnea. I was the first surgeon in the Western US to offer it to patients after FDA approval in 2014, and I have seen the tremendous difference it has made… Read more »

Nashville, TN was the site of both the 2023 International Surgical Sleep Society (ISSS) Educational Symposium and American Academy of Otolaryngology – Head and Neck Surgery Foundation Annual Meeting. It is always wonderful to see colleagues and long-time friends. However, I wanted to take the chance to share some of what I found to be… Read more »

In the United States and many other countries, obstructive sleep apnea surgery is generally considered a second-line therapy for patients who do not tolerate or benefit from positive airway pressure therapy (for example, continuous positive airway pressure, or CPAP). This is based on two arguments: Surgery clearly has greater risks than CPAP Surgery does not… Read more »

I have written previously on this blog about our research highlighting the extremely low quality of published “systematic reviews” and “meta-analyses” in the otolaryngology and sleep surgery literature. We have shown that many studies do not adhere to established, accepted research methods for these studies, creating a dangerous situation where publications that pretend to be… Read more »

Surgery for obstructive sleep apnea often involves surgery of the throat that removes, repositions, and/or tightens tissue. Although the goal is to improve or eliminate the sleep apnea, the risks include the potential to disrupt normal function, especially speech and swallowing. Fortunately, speech changes have always been rare, but changes in swallowing have always been… Read more »

Upper Airway Stimulation (Inspire Medical Systems, Golden Valley, MN, USA) is an excellent treatment option for many patients with moderate to severe obstructive sleep apnea who are unable to tolerate positive airway pressure therapy (for example, CPAP or BPAP) well. There are a number of specific criteria to determine whether a patient is eligible for… Read more »

When patients with obstructive sleep apnea cannot tolerate positive airway pressure therapy (e.g., CPAP), they should consider other treatment options, including surgery and oral appliances. My career has focused on the surgical evaluation and treatment of obstructive sleep apnea and snoring. When I started in this field, the main surgical option was traditional uvulopalatopharyngoplasty, and… Read more »