To the Editor: The recent article by Elshaug and colleagues identifying potentially low-value health care practices1 does not distinguish between surgery for obstructive sleep apnoea (OSA) in adults (which is largely used as an adjunctive or salvage intervention in Australia) and children (which is primarily a first-line intervention).
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- 1. Elshaug AG, Watt AM, Mundy L, Willis CD. Over 150 potentially low-value health care practices: an Australian study. Med J Aust 2012; 197: 556-560. <MJA full text>
- 2. Weaver EM, Maynard C, Yueh B. Survival of veterans with sleep apnea: continuous positive airway pressure versus surgery. Otolaryngol Head Neck Surg 2004; 130: 659-665.
- 3. Franklin KA, Anttila H, Axelsson S, et al. Effects and side-effects of surgery for snoring and obstructive sleep apnea — a systematic review. Sleep 2009; 32: 27-36.
- 4. Weaver EM. Judging sleep apnea. Sleep Med Rev 2010; 14: 283-285.
- 5. Kezirian EJ, Malhotra A, Goldberg AN, White DP. Changes in obstructive sleep apnea severity, biomarkers, and quality of life after multilevel surgery. Laryngoscope 2010; 120: 1481-1488.
- 6. Epstein LJ, Kristo D, Strollo PJ Jr; Adult Obstructive Sleep Apnea Task Force of the American Academy of Sleep Medicine. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med 2009; 5: 263-276.
- 7. Field CJ, Robinson S, MacKay S, et al. Clinical equipoise in sleep surgery: investigating clinical trial targets. Otolaryngol Head Neck Surg 2011; 145: 347-353.
- 8. MacKay SG, Carney AS, Woods C, et al. Modified uvulopalatopharyngoplasty and coblation channelling of the tongue for obstructive sleep apnea: a multi-centre Australian trial. J Clin Sleep Med 2013. In press.
- 9. Robinson S, Chia M, Carney AS, et al. Upper airway reconstructive surgery long-term quality of life outcomes compared with CPAP for adult obstructive sleep apnea. Otolaryngol Head Neck Surg 2009; 141: 257-263.
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This letter is supported by the Australian Society of Otolaryngology Head and Neck Surgery.
No relevant disclosures.