Trends in otolaryngology residency training in the surgical treatment of obstructive sleep apnea

Authors

  • Michael W. Sim MD,

    Corresponding author
    1. Department of Otolaryngology–Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan, U.S.A
    • Send correspondence to Michael Sim, MD, 1500 E. Medical Center Dr., 1904 Taubman Center Ann Arbor, MI 48109-5312. E-mail: michaelsim@gmail.com

    Search for more papers by this author
  • Jeffrey J. Stanley MD

    1. Sleep Disorders Center, Department of Otolaryngology–Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan, U.S.A.
    Search for more papers by this author

  • This study was presented as a poster presentation at SLEEP 2011, the 25th Annual Meeting of the Associated Professional Sleep Societies, LLC (APSS), Minneapolis, Minnesota, U.S.A, June 6–8, 2011.

  • This study was conducted at the University of Michigan Health System. The authors have no funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis

Most patients with obstructive sleep apnea (OSA) have multilevel obstruction. Improved outcomes with multilevel surgery compared to isolated palatal surgery have been well documented. Despite this, surgical practice patterns in the United States have been slow to change. The purpose of this study was to evaluate whether current practice patterns are a reflection of limited surgical residency training in hypopharyngeal procedures.

Study Design

Cross-sectional Internet survey.

Methods

Program directors from 103 accredited U.S. otolaryngology residency programs were surveyed regarding past (2000, 2005) and more recent (2010) resident surgical competency in operative techniques for treatment of OSA.

Results

Of the 48 survey respondents, 85%, 90%, and 100% reported resident surgical competency for oropharyngeal procedures in 2000, 2005, and 2010, respectively. Uvulopalatopharyngoplasty and tonsillectomy were the most common procedures reported in all 3 years. In contrast, 63%, 71%, and 83% reported resident surgical competency for hypopharyngeal procedures in 2000, 2005, and 2010. Lingual tonsillectomy was the most common procedure in all 3 years.

Conclusion

Surgical practice patterns in the United States do not reflect current practice recommendations for treatment of OSA, which emphasize multilevel surgery. Limited surgical residency training in hypopharyngeal procedures may be a contributing factor, although there appears to be an increasing trend in resident competency. Improvement in the scope of resident surgical training for treatment of OSA may lead to improved surgical outcomes.

Level of Evidence

3b. Laryngoscope, 124:579–582, 2014

Ancillary