title: Pang-Rotenberg sign--snoring surgery prognosticator: A prospective clinical trial of 153 patients.
abstract: OBJECTIVE
  To illustrate the reliability of the Pang-Rotenberg (PR) sign as a prognosticator of snoring surgery. Our hypothesis was that patients who are PR-positive have better snoring reduction scores and outcomes than PR-negative patients after nose and palate surgery.
  
  
  METHODS
  A multicenter prospective series of 153 patients with snoring.
  
  
  METHODS
  All patients graded the snoring intensity on a visual analog scale (VAS). All 137 patients enrolled had both the nose surgery and palate surgery. The control group consisted of 16 patients who underwent nasal surgery alone.
  
  
  RESULTS
  There were 122 men and 15 women, the mean age was 44.6 years old, and mean body mass index was 26.1. There were 15 simple snorers and 122 obstructive sleep apnea patients. Patients who were PR-positive showed significantly better postoperative snoring VAS reduction (from 9.04 to 1.02) compared to those patients who were PR-negative (from 8.91 to 3.14) (P < .001). The mean follow-up time was 7.4 months. The control group had poor snoring VAS reduction from 9.21 to 6.72. After adjusting for covariates that influence the snoring VAS change due to surgery, we found that PR-negative patients achieved an average of 5.78 improvement in snoring VAS, whereas PR-positive patients achieved an average of 8.02 improvement in snoring VAS (P < .001).
  
  
  CONCLUSIONS
  The PR sign is a reliable prognosticator of snoring reduction, after combined nose and palate surgery, for patients with troublesome snoring.
authors.affiliation: Department of Otolaryngology, Asia Sleep Centre, Paragon Medical, Singapore.
authors.forename: Kenny P
authors.initials: KP
authors.lastname: Pang
authors.affiliation: Department of Otolaryngology, Nova Specialty Hospital, Hyderabad, India.
authors.forename: Srivinas
authors.initials: S
authors.lastname: Kishore
authors.affiliation: Department of Otolaryngology, Tuen Mun Hospital, Hong Kong.
authors.forename: Joseph Chung Chun
authors.initials: JC
authors.lastname: Kit
authors.affiliation: Department of Otolaryngology, Asia Sleep Centre, Paragon Medical, Singapore.
authors.forename: Edward B
authors.initials: EB
authors.lastname: Pang
authors.affiliation: Biostatistics Unit, Dean's Office School of Medicine, National University, Singapore.
authors.forename: Yiong Huak
authors.initials: YH
authors.lastname: Chan
authors.affiliation: Department of Otolaryngology, Tan Tock Seng Hospital, Singapore.
authors.forename: Siow Jin
authors.initials: SJ
authors.lastname: Keat
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada.
authors.forename: Brian
authors.initials: B
authors.lastname: Rotenberg
mesh_terms: D000328:Adult; D000368:Aged; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009666:Nose / Q000601:surgery*; D010159:Palate / Q000601:surgery*; D017286:Polysomnography; D011446:Prospective Studies; D012913:Snoring / Q000601:surgery*; D016896:Treatment Outcome
keywords: Pang-Rotenberg sign; obstructive sleep apnea; snoring reduction