title: Trends in otolaryngology residency training in the surgical treatment of obstructive sleep apnea.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
  
  
  METHODS
  3b.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan, U.S.A.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Sim
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Stanley
mesh_terms: D003430:Cross-Sectional Studies; D006801:Humans; D007396:Internship and Residency / Q000639:trends*; D010036:Otolaryngology / Q000193:education*; D010818:Practice Patterns, Physicians'; D020181:Sleep Apnea, Obstructive / Q000601:surgery*
keywords: Obstructive sleep apnea; multilevel surgery; practice patterns; residency training; resident education