ABSTRACT
The study of upper airway dynamics in obstructive sleep apnea syndrome (OSAS) has always posed a challenge to the interested. Until the dynamics in OSA is well understood, treatment options cannot be comprehensive. To date, continuous positive airway pressure (CPAP) remains the most efficacious first-line treatment as it stents open the entire upper airway without the need for prior knowledge of the dynamics in OSA. Many patients are, nevertheless, not amenable to its lifelong use. Support is important for this group of patients, particularly if surgical or non-surgical options other than CPAP can alleviate, if not cure. The much disfavored tracheostomy with all its unpleasant problems is known to help in OSAS and has achieved the best long-term survival (1,2). This confirms the importance of an understanding of the dynamics of the upper airway above the glottis in OSAS, especially if effective surgery is to be designed.
