A Survey of Sleep Medicine Physician Perceptions on the Surgical Treatment of Obstructive Sleep Apnea

Publication date: Available online 18 December 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Jonathan J. Swope, Marcus A. Couey, James W. Wilson, Jonathon S. Jundt
PurposeSurgical treatment for obstructive sleep apnea (OSA) varies by specialty. This survey sought to answer three principal questions: 1) To which surgical specialists are sleep physicians referring for upper airway surgery? 2) Which surgical treatment do sleep specialists find to be most effective in treating OSA? 3) Do sleep medicine physicians believe that maxillomandibular advancement (MMA) is worthwhile to patients who are surgical candidates?Materials and MethodsThe Investigators formulated a cross-sectional survey. Study sample was obtained by identifying all practices that advertised as sleep medicine specialists in Houston, TX by using internet searches. Physicians who treated children were excluded. 79 surveys were hand-delivered to offices in the greater Houston area, which included six questions to determine referral and surgical preferences for obstructive sleep apnea. Variable responses included years in practice, specialty, and a comments section. A 10-point likert scale was used to assess sleep medicine physician's referral patterns and perceptions regarding surgical treatment of OSA. Numerical data was analyzed by calculating mean values, and by dividing responses into "disagree" (<5), "neutral" (=5), and "agree" (>5).Results26 surveys were returned. More sleep medicine physicians referred to ENT Surgeons (52%) than to OMS Surgeons (20%). MMA was viewed as the most effective surgery (72%), followed by "none" (16%), "other" (8%) and UPPP (4%). More respondents viewed the benefits versus risks as favorable for MMA (44%) than for UPPP (29%).ConclusionsResults of this survey demonstrate that sleep medicine physicians in the greater Houston area view MMA as the most favorable and effective surgical option for treating OSA. While MMA was most often referred for, more respondents refer to ENT than to OMS for surgical management of OSA. Years in practice displayed no correlation in referral patterns or preference for type of OSA surgery.



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