Evidence map›Paper›PMID 39833433›Full record

ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2025

Effect of multi-level upper airway surgery on obese patients with obstructive sleep apnea.

Mahmoud Ebrahim, Salman Hussain, Mohammed Al-Bader, Hiba Abdulateef, Mutlaq AlSihan, Nico de Vries, Abdulmohsen AlTerki

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Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Mahmoud EbrahimDepartment of Otolaryngology-Head and Neck Surgery, McGill, Montreal, Canada.
Salman HussainDepartment of Otolaryngology-Head and Neck Surgery, University of Ottawa, Ottawa, ON, Canada. q80salman98@gmail.com.ORCID http://orcid.org/0000-0001-7287-7694
Mohammed Al-BaderDepartment of Otolaryngology-Head and Neck Surgery, Zain Hospital, Kuwait City, Kuwait.
Hiba AbdulateefDepartment of Otolaryngology-Head and Neck Surgery, Zain Hospital, Kuwait City, Kuwait.
Mutlaq AlSihanDepartment of Otolaryngology-Head and Neck Surgery, Zain Hospital, Kuwait City, Kuwait.
Nico de VriesDepartment of Otorhinolaryngology and Head and Neck Surgery, OLVG, Amsterdam, The Netherlands.
Abdulmohsen AlTerkiDepartment of Otolaryngology-Head and Neck Surgery, Zain Hospital, Kuwait City, Kuwait.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeObesity is a major risk factor in Obstructive sleep apnea (OSA), which is a prevalent disease that leads to significant morbidity. Multi-level Sleep Surgery (MLS) is a method of treatment for patients who cannot tolerate continuous positive airway pressure. Obesity has previously been identified as a risk factor that may decrease the success rate of MLS. The purpose of our study is to assess the success rates of MLS in obese patients.

methodsA retrospective cohort study in 109 adults that underwent MLS in our institution. All the participants completed pre-operative and post-operative level 1 polysomnography. They were divided into four groups as per their body mass index (BMI): Normal (BMI < 25), overweight (25-30), obese (30-35), morbid obese (> 35) and the variables were compared. We measured the surgical success as defined by Sher Criteria (AHI drop > 50% from preoperative baseline and AHI < 20) and cure rates (AHI < 5).

resultsThe average BMI was 30.9 pre-op and 30.4 post-op. The mean AHI was 29.8 pre-op and decreased to 10.1 (p < 0.001) and the Epworth Sleepiness Scale from 12.9 to 4.8 (p < 0.001). There were 13, 31, 43, and 22 patients in normal, overweight, obese and morbidly obese groups, respectively. The surgical success rate as defined by Sher's criteria was 84%, 84%, 72%, and 77% in the respective groups, with no statistical difference (p = 0.662). Moreover, the cure rate was 77%, 45%, 44%, and 45%, with no statistical difference (p = 0.192). The AHI reduction was 9.93, 19.73, 21.1 and 22.8 in the respective groups. A linear regression analysis revealed no significant difference in assessing the surgical success and cure rates as BMI increases.

conclusionData regarding MLS success rates on obese patients is scarce. The current study demonstrates that MLS can offer positive outcomes for this population. However, further studies are warranted to investigate this relationship. LEVEL OF EVIDENCE: 3:

Indexed as

ObesitySleep Apnea, ObstructiveAdultBody Mass IndexFemaleHumansMaleMiddle AgedObesity, MorbidPolysomnographyRetrospective StudiesTreatment OutcomeObesityObstructive sleep apneaOutcomeSleep surgery

Identifiers

PMID39833433

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.