We thank Dr Singh for his interest in and comments on our manuscript [1, 2]. Firstly, it is important to note that these data were collected as part of a multicentre randomized trial: The Sleep Apnea Multilevel Surgery (SAMS) trial [3, 4]. The need for this trial was born out of the lack of randomized clinical trial evidence for multilevel surgery (targeting the soft palate and posterior tongue), which is critical to reliably inform clinical practice of the effectiveness of this intervention for obstructive sleep apnea (OSA). The SAMS trial confirmed benefit of multilevel surgery in terms of OSA improvement by reduction in both OSA severity (apnea–hypopnea index [AHI]) and daytime sleepiness (Epworth Sleepiness Score [ESS]) compared to the control group in OSA patients for whom conventional device treatment had failed.
- obstructive sleep apnea
- magnetic resonance imaging
- multilevel upper airway surgery
- tongue fat