A Clinically Relevant Threshold of Impaired Contrast Sensitivity Among Older US Adults.

Patient‐reported outcome measures (PROMs) are essential for evaluating surgical treatments from a patient‐centered perspective [, , ]. Although multiple PROMs exist for snoring and obstructive sleep apnea (OSA) surgery, many are insufficiently validated [], and no consensus on their use has been reached [, , ]. This lack of standardization limits comparability across studies using PROMs for patient‐centered care [], so outcome studies often emphasize objective metrics such as the apnea‐hypopnea index (AHI). While AHI reductions following palatopharyngeal surgery are well documented, many patients, particularly those with primary snoring or mild disease, prioritize symptomatic improvements over objective physiological measures [, , ]. A decrease in snoring intensity and relief of daytime sleepiness are often primary reasons for undergoing surgery. Excessive daytime sleepiness can compromise daily activities and overall quality of life [, , ]. Snoring can have a profound impact on both the person experiencing it and those around them [, ]. Palatopharyngeal surgery is frequently performed to treat snoring and OSA with generally proven effectiveness [, , ]. Fujita et al. first described the uvulopalatopharyngoplasty (UPPP) in 1981 []. The classical UPPP involved tonsillectomy and removal of soft tissue in the oropharynx, followed by approximation with resorbable sutures. Over time, several modifications to this technique have been described to stabilize the oropharyngeal airway during sleep. They focus on muscle relocation rather than tissue resection [, ] and often employ technological advances, such as radiofrequency ablation, laser, powered instruments, and implants. These modifications aim to improve effectiveness and palatopharyngeal function while reducing tissue removal [, ] and complications such as foreign body sensation, velopharyngeal insufficiency, and dry mouth []. Additionally, modern modifications are increasingly performed as outpatient procedures, reducing hospital stays, sick days, and healthcare costs. The overall effectiveness of palatopharyngeal surgery in improving both objective and subjective outcomes has been well demonstrated [, , ]. We have previously shown the technique‐dependent differences in the effectiveness of palatopharyngeal surgery in reducing AHI []. To date, no comparative analysis has specifically evaluated palatopharyngeal surgical modifications regarding PROMs. Given the central role of PROMs in patient‐centered care and surgical decision‐making for patients with snoring and OSA, understanding the comparative effectiveness of these techniques on symptom outcomes is essential for informed patient counseling and surgical planning. Accordingly, this meta‐analysis compares palatopharyngeal surgery modifications without tonsillectomy with respect to daytime sleepiness and snoring intensity, providing evidence to guide treatment decisions.