Surgical Outcomes for Obstructive Sleep Apnea in Korea

Obstructive sleep apnea (OSA) is a common chronic sleep disorder that causes oxygen desaturations, sympathetic hyperactivation, and sleep fragmentation. The gold standard for OSA treatment in adults is positive airway pressure (PAP) therapy, which is effective when used during sleep. However, about half of patients with OSA refuse or are non-adherent to PAP, and some patients have anatomical problems that can be alleviated surgically. Surgery can be considered for patients who are very likely to have successful surgical results, but who are intolerant to PAP or oral appliances because of anatomical abnormalities. There are various surgical modifications of the upper airway for OSA, including nasal surgeries (e.g., septoplasty, turbinoplasty, and endoscopic sinus surgery), nasopharyngeal surgeries, oral and oropharyngeal surgeries (e.g., uvulopalatopharyngoplasty and variations, tonsillectomy, and palatal implants), hypopharyngeal surgeries (e.g., tongue ablation, tongue-base resection, and genioglossus advancement), and multi-level surgeries. Much clinical research has reported the outcomes of various surgical procedures for OSA internationally based on the traditional surgical success rate (defined as ≥ 50% reduction in the postoperative apnea-hypopnea index [AHI], postoperative AHI < 20), and AHI reduction ratio (defined as between the preoperative and postoperative AHI). In addition, many studies investigating the results of various OSA surgeries have been reported in Korea. In this article, we review the characteristics of various upper airway surgical procedures for OSA, global surgical results for OSA, and current surgical outcomes for OSA in Korea.