Evaluation of the patient with obstructive sleep apnea: Friedman tongue position and staging

Obstructive sleep apnea or hypopnea syndrome often results from obstruction at multiple anatomical sites. Consideration of the complex relationship between sites of obstruction is paramount to choosing the correct surgical approach to treatment. Selection of patients who are likely to respond to surgery necessitates perioperative evaluation of individual patient anatomy. Surgical staging of obstructive sleep apnea or hypopnea syndrome has been shown to be an accurate predictor of surgical success with uvulopalatopharyngoplasty, and can also be applied to predict patients who may be candidates for other treatments. We present our anatomical staging system and a grading system for lingual tonsil hypertrophy.