THIS IS WHERE DISCOVERIES ARE BORN!

Professor Ewa Olszewska and co-authors from other universities published a series of three articles in the Journal of Clinical Medicine under the common title: “Consensus statements among European sleep surgery experts on snoring and obstructive sleep apnea”. Prof Ewa Olszewska is the first author of all three publications, and the other co-authors are experts from Germany, Spain, Italy, England and Belgium. 

This series of papers presents a consensus on diagnostic procedures, surgical methods, and postoperative treatment in sleep surgery for obstructive sleep apnea syndrome (OSA) and snoring. The first paper presents consensus on the definition and diagnostic management, the second on surgical treatment decision-making and perioperative recommendations and the third on surgical methods in oropharynx, postoperative outcomes, recommendations and complications. Using the Delphi method, a panel of eight experts from different European countries evaluated the individual claims presented by Prof. Olszewska. All responses to the individual claims, contributions, and comments were anonymous. Only Prof. Olszewska, as a leading author of the publications, had access to them. 

In the end, 281 statements were created and evaluated by panelists in five rounds. After each round, the statements were modified. A consensus was obtained when at least 75% of the panellists agreed or disagreed with a given statement. A consensus was obtained on 91.5% of all statements. The highest level of consensus was obtained for definitions (100%), followed by postoperative management (70%), and the lowest was for diagnostic management (58.3%). 

The panelists evaluated 33 statements related to treatment decision-making (consensus was obtained in 91.2% of statements). A set of 111 claims regarding palatal surgery was also developed (consensus was obtained in 91.2% of statements). The experts emphasized the importance of an individualized approach in the choice of surgical method and the use of Drug-Induced Sleep Endoscopy (DISE) of the upper airway to assess the type and site of obstruction, palatal phenotype and upper airway collapse at particular levels. The study also highlighted the possibility of multiple treatment options and the influence of factors such as patient age, weight, and comorbidities on these choices. Personalization of the diagnostic and therapeutic management of OSA and snoring is crucial. It was pointed out that non-surgical methods such as weight loss, myofunctional therapy, oral appliaces or positive airway pressure therapy should be considered before surgical interventions. 

Also, 38 statements on perioperative management (consensus in 89.5% of statements), 10 on postoperative management (consensus in 70% of statements), 43 on treatment outcomes and follow-up visits (consensus in 81.4% of statements) and 24 on complications (consensus in 95.8% of statements) were developed. The arduous and time-consuming consensus process was aimed at unifying standards of care and improving patient outcomes across healthcare systems. The results of the study reflect the complexity and diversity of the treatment of snoring and OSA, highlighting the need to standardize the diagnostic and therapeutic management of OSA and snoring.

Link to the articles: Consensus Statements among European Sleep Surgery Experts on Snoring and Obstructive Sleep Apnea: Part 1

Consensus Statements among European Sleep Surgery Experts on Snoring and Obstructive Sleep Apnea: Part 2

Consensus Statements among European Sleep Surgery Experts on Snoring and Obstructive Sleep Apnea: Part 3