Advances in Surgical Treatment of Obstructive Sleep Apnea

Obstructive Sleep Apnea (OSA) is a common yet underdiagnosed sleep disorder characterized by repetitive upper airway collapse during sleep, leading to fragmented sleep architecture, intermittent hypoxia, and substantial cardiovascular and neurocognitive morbidity. While continuous positive airway pressure (CPAP) remains the cornerstone of treatment, long-term adherence is often suboptimal. As a result, surgical interventions have become an increasingly important therapeutic option, particularly for patients with moderate to severe OSA who are intolerant or unresponsive to non-invasive therapies.

In recent years, surgical treatment of OSA has undergone significant evolution. Traditional approaches such as uvulopalatopharyngoplasty (UPPP) have been augmented or replaced by a wide range of newer techniques, including site-specific, multilevel, and minimally invasive surgeries. The introduction of hypoglossal nerve stimulation, robotic-assisted upper airway surgeries, and advanced diagnostic tools such as drug-induced sleep endoscopy (DISE) has revolutionized patient selection, treatment planning, and surgical outcomes. Moreover, innovations in imaging and computational modeling now offer the potential for more personalized, anatomy-guided surgical interventions.

Despite these advancements, significant challenges remain. The comparative effectiveness of various surgical modalities, the long-term durability of outcomes, and the identification of optimal patient selection criteria are areas still requiring rigorous investigation. Furthermore, surgical education, training pathways, and accessibility to high-precision technologies vary widely across institutions and regions, impacting the global standardization of care.

This Research Topic aims to comprehensively explore the state-of-the-art surgical management of OSA, emphasizing technological innovation, clinical outcomes, and future directions. We encourage original research, systematic reviews, clinical trials, and translational studies that critically examine the evolving role of surgery in treating OSA.

Topics of interest include, but are not limited to:

• Multilevel and site-specific surgical strategies for OSA
• Hypoglossal nerve stimulation and other implantable devices
• Robotic and endoscopic-assisted upper airway surgeries
• Advances in imaging and computational modeling for surgical planning
• Role of DISE and other diagnostic modalities in guiding surgical decision-making
• Pediatric OSA surgery: challenges and innovations
• Comparative effectiveness studies of surgical vs. non-surgical interventions
• Long-term outcomes, patient-reported measures, and quality of life after surgery
• Learning curves, surgeon experience, and educational approaches
• Global accessibility and health-economic implications of surgical OSA management

This Topic seeks to bring together multidisciplinary insights from otolaryngology, oral and maxillofacial surgery, sleep medicine, and biomedical engineering to highlight how modern surgical strategies are reshaping OSA care. By fostering collaboration across specialties and geographies, we aim to bridge current knowledge gaps and support the development of evidence-based, patient-centered surgical practices.

The Topic Editors declare no competing interests with regard to the Research Topic subject.

Keywords: Obstructive Sleep Apnea, Sleep-Disordered Breathing, Surgical Intervention, Upper Airway Surgery, Robotic Surgery, Hypoglossal Nerve Stimulation, Implantable Devices, Endoscopic-Assisted Surgery

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.