The DOI matches its Crossref record; 29 of the 29 references it cites were found in a registry or an index.
Anatomic and Pathophysiologic Considerations in Surgical Treatment of Obstructive Sleep Apnea
Abstract
Evaluation of the upper airway is key for a successful surgical management. Proper evaluation can be done only with a good understanding of the anatomy and pathophysiology of the upper airway. The authors discuss surgical anatomy from a soft tissue and bony perspective in detail along with its clinical implications. The complex interaction among pharyngeal dilator tone, arousal threshold, respiratory control instability, and changes in lung volume during sleep play an important role in obstructive sleep apnea. Because all the anatomic and physiologic characteristics discussed have genetic predisposition, gene therapy may play a pivotal role in the future.
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“in OSA patients, after overcoming the critical closing pressure (Pcrit), a partial or total airway collapse will happen.”
From Role of Nasal Surgery in Adult Obstructive Sleep Apnea: A Systematic Review (2024) · cites this paper as [40]
Citations
Cites
Effects of Age on Sleep Apnea in Men: I. Prevalence and Severity
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Pathophysiology of Adult Obstructive Sleep Apnea
Eckert, D. J., & Malhotra, A. (2008) · Proceedings of the American Thoracic Society · doi:10.1513/pats.200707-114mg · Cited by 719
Factors inducing periodic breathing in humans: a general model
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Björk, A. (1955) · American Journal of Orthodontics · doi:10.1016/0002-9416(55)90005-1 · Cited by 494
Effect of Weight Loss on Upper Airway Collapsibility in Obstructive Sleep Apnea
Schwartz, A. R., Gold, A. R., Schubert, N., Stryzak, A., Wise, R. A., Permutt, S., & Smith, P. L. (1991) · American Review of Respiratory Disease · doi:10.1164/ajrccm/144.3_pt_1.494 · Cited by 477
Pharyngeal Fat in Obstructive Sleep Apnea
Shelton, K. E., Woodson, H., Gay, S., & Suratt, P. M. (1993) · American Review of Respiratory Disease · doi:10.1164/ajrccm/148.2.462 · Cited by 458
Role of Arousals in the Pathogenesis of Obstructive Sleep Apnea
Younes, M. (2004) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200307-1023oc · Cited by 456
The Male Predisposition to Pharyngeal Collapse: Importance of Airway Length
Malhotra, A., Huang, Y., Fogel, R. B., Pillar, G., Edwards, J. K., Kikinis, R., Loring, S. H., & White, D. P. (2002) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.2112072 · Cited by 441
The Influence of Increasing Ventilatory Effort on Arousal from Sleep
Gleeson, K., Zwillich, C. W., & White, D. P. (1990) · American Review of Respiratory Disease · doi:10.1164/ajrccm/142.2.295 · Cited by 411
Cited by
Suurna, M. V., Jacobowitz, O., Chang, J. L., Koutsourelakis, I., Smith, D. F., Alkan, U., D׳Agostino, M. A., Boon, M. S., Heiser, C., Hoff, P. T., et al. (2021) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.9542 · Cited by 38
Gurgel, M., Cevidanes, L., Pereira, R. R. R., Costa, F. W. G., Ruellas, A. C. D. O., Bianchi, J., Cunali, P. A., Bittencourt, L., & Chaves, C. M. (2021) · Clinical Oral Investigations · doi:10.1007/s00784-021-04066-5 · Cited by 18
Role of Nasal Surgery in Adult Obstructive Sleep Apnea: A Systematic Review
Correa, E. J., Conti, D. M., Moreno-Luna, R., Sánchez-Gómez, S., & O'Connor Reina, C. (2024) · Sleep Science · doi:10.1055/s-0044-1782527 · Cited by 15
Dallan, I., Cristofani‐Mencacci, L., Seccia, V., Cambi, C., Fiacchini, G., Berrettini, S., & Brevi, B. C. (2019) · European Archives of Oto-Rhino-Laryngology · doi:10.1007/s00405-019-05671-7 · Cited by 9
Kuo, Y.-H., Liu, T.-J., Chiu, F., Chang, Y., Lin, C., Jacobowitz, O., & Hsu, Y. (2021) · Nature and Science of Sleep · doi:10.2147/nss.s327770 · Cited by 7
Oral Appliances for Severe Positional Obstructive Sleep Apnea Syndrome: A Case Report
Memè, L., Saccomanno, S., Strappa, E. M., Sampalmieri, F., Bambini, F., & Gallusi, G. (2022) · Applied Sciences · doi:10.3390/app122010570 · Cited by 3
Li, H., Jing, C., Shouyi, W., Lei, X., Li, Q., Fenghe, Z., & Yongzhi, P. (2025) · Clinical Oral Investigations · doi:10.1007/s00784-025-06182-y · Cited by 2
Schulz, K. L., Matta, R. E., Nobis, C.-P., Möst, T., Kesting, M. R., & Lutz, R. (2024) · Clinical Oral Investigations · doi:10.1007/s00784-024-05646-x · Cited by 1
Considerations of Facial Skeletal Morphology to Optimize Upper Airway Stimulation
Liu, S. Y., & Abdelwahab, M. (2022) · Springer eBooks · doi:10.1007/978-3-030-89504-4_6
Respiratory disorders in children with syndromic craniosynostosis: pathogenesis and diagnosis
Azarova, N. A., Shelesko, E. V., Satanin, L. A., Tere, V. A., Karnaukhova, A. V., Topolnitsky, O. Z., Azarov, A. A., & Alyaeva, O. O. (2025) · Folia Otorhinolaryngologiae et Pathologiae Respiratoriae · doi:10.17816/fopr698399
Zhang, P., & Liang, D. (2026) · Frontiers in Surgery · doi:10.3389/fsurg.2026.1747801
Metadata
- Authors
- Sistla, S. K., Paramasivan, V. K., & Agrawal, V.
- Affiliations
- Star Hospitals (IN)
- Corresponding author
- Sistla, Srinivas Kishore
- Venue
- Sleep Medicine Clinics
- Publisher
- Elsevier BV
- Published
- 2019-03
- Volume
- 14
- Issue
- 1
- Pages
- 21-31
- ISSN
- 1556-407X (ISSN-L)
- OpenAlex
- W2914339183
- Cited by
- 11
- References
- 29
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2022: 2 · 2021: 3 · 2019: 1
- FWCI
- 1.03
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Sleep Medicine Clinics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
- Keywords
- obstructive sleep apnea, upper airway anatomy, upper airway surgery, arousal threshold, genetic susceptibility, gene therapy
- MeSH terms
- Arousal, Humans, Pharynx, Sleep, Sleep Apnea, Obstructive
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