The progression of surgical management of obstructive sleep apnea

Objective To document and contextualize the historical and technical evolution of surgical managmenet for obstructive sleep apnea (OSA). Findings Surgical management of OSA requires comprehensive preoperative evaluation to identify all anatomic subsites of airway collapse, which has been standardized through techniques such as drug-induced sleep endoscopy. The field has evolved from isolated, site-specific interverentions to integrated, multilevel approaches, originally popularized by the Stanford two-phase protocol. Ongoing innovation continues to redefine surgeon practice, exemplified by the recent era of neuromodulation, including the hypoglossal nerve stimulator. Conclusion OSA surgical success requires a multidisciplinary, patient-specific approach, which necessitates the sleep surgeon to be well-versed on the latest surgical techniques and technological advancements