TY - JOUR
T1 - Hypopharyngeal surgery in obstructive sleep apnea
T2 - Practice patterns, perceptions, and attitudes
AU - Kezirian, Eric J.
AU - Hussey, Heather M.
AU - Brietzke, Scott E.
AU - Cohen, Seth M.
AU - Davis, Greg E.
AU - Shin, Jennifer J.
AU - Weinberger, Debra G.
AU - Cabana, Michael D.
N1 - Funding Information:
Funding source: This study was sponsored by the American Academy of Otolaryngology—Head and Neck Surgery and was supported by the Outcomes Research and Evidence-Based Medicine Subcommittee and the Sleep Disorders Committee. Dr Kezirian was supported by a career development award from the National Center for Research Resources (NCRR) of the National Institutes of Health (NIH), under NIH/NCRR/OD UCSF-CTSI Grant Number KL2 RR024130. Dr Davis is partially supported by a career development award from NCRR, under Grant Number KL2 RR025015. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH or the American Academy of Otolaryngology—Head and Neck Surgery.
PY - 2012/11
Y1 - 2012/11
N2 - Objective. To characterize factors that surgeons perceive as affecting selection of procedures designed to treat hypopharyngeal obstruction in adults with obstructive sleep apnea (OSA) and to compare those factors among 2 groups of American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) member surgeons. Study Design. Cross-sectional online survey. Subjects and Methods. AAO-HNS members with a selfidentified subspecialty interest either in sleep medicine or general otolaryngology were asked to complete an online survey, each respondent rated (5-point Likert scale) the perceived quality of their education and training and the role of specific factors in selection, both for procedure categories (eg, all hypopharyngeal) and individual procedures. Responses were examined for the entire group and for subgroups. Results. Response rate was 27% (163/610). Sixty-five percent of respondents rated their surgical OSA education and training during postgraduate continuing medical education (CME) courses as of high quality, compared with 39% for residency/fellowship and 4% for medical school (P< 0.01). For individual hypopharyngeal procedures, over 40% of respondents reported limited training (except for tongue radiofrequency), and over 30% raised concerns about scientific evidence and reimbursement. Surgeon personal experience suggested treatment benefits without clearly favoring individual procedures. Respondents noted that patients were reluctant to undergo procedures, despite treatment recommendations, particularly maxillomandibular advancement. The sleep medicine subgroup reported higher ratings for education and training quality, research evidence, and personal experience with hypopharyngeal procedures. Concerns about adequate education and training, the quality of research evidence, and reimbursement issues were major factors in procedure selection. Conclusion. Multiple factors affect procedure selection. Surgeons identify concerns regarding education and training and research evidence.
AB - Objective. To characterize factors that surgeons perceive as affecting selection of procedures designed to treat hypopharyngeal obstruction in adults with obstructive sleep apnea (OSA) and to compare those factors among 2 groups of American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) member surgeons. Study Design. Cross-sectional online survey. Subjects and Methods. AAO-HNS members with a selfidentified subspecialty interest either in sleep medicine or general otolaryngology were asked to complete an online survey, each respondent rated (5-point Likert scale) the perceived quality of their education and training and the role of specific factors in selection, both for procedure categories (eg, all hypopharyngeal) and individual procedures. Responses were examined for the entire group and for subgroups. Results. Response rate was 27% (163/610). Sixty-five percent of respondents rated their surgical OSA education and training during postgraduate continuing medical education (CME) courses as of high quality, compared with 39% for residency/fellowship and 4% for medical school (P< 0.01). For individual hypopharyngeal procedures, over 40% of respondents reported limited training (except for tongue radiofrequency), and over 30% raised concerns about scientific evidence and reimbursement. Surgeon personal experience suggested treatment benefits without clearly favoring individual procedures. Respondents noted that patients were reluctant to undergo procedures, despite treatment recommendations, particularly maxillomandibular advancement. The sleep medicine subgroup reported higher ratings for education and training quality, research evidence, and personal experience with hypopharyngeal procedures. Concerns about adequate education and training, the quality of research evidence, and reimbursement issues were major factors in procedure selection. Conclusion. Multiple factors affect procedure selection. Surgeons identify concerns regarding education and training and research evidence.
KW - Evidence-based medicine
KW - Health services research
KW - Sleep medicine
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U2 - 10.1177/0194599812453000
DO - 10.1177/0194599812453000
M3 - Article
C2 - 22753614
AN - SCOPUS:84872030724
SN - 0194-5998
VL - 147
SP - 964
EP - 971
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
IS - 5
ER -