Restoration of Missed Milestones in Airway Development for Sleep
About a year ago, I attended the World Sleep Congress as one of the keynote speakers. The selection was a surprising honor for me. I felt grateful to present as a surgeon. It wasn’t always that surgeons had a recognized role in the treatment of patients with obstructive sleep apnea (OSA).
World Sleep 2023
Sleep surgery as restoring missed milestones
in airway growth & development
When I first Dr. Nelson Powell, my career mentor, he told me about a debate between surgery and medicine’s roles in the treatment of OSA, featured in the Journal of Clinical Sleep Medicine.
This was a fair, professional, and peer-reviewed debate – unfortunately rarer than it should be. Today, weaponization of academic medicine towards its constituents matches misuse of our justice system. Professional envy in academia has no boundary.[1]
The “Con” side for upper airway surgery in the treatment of OSA was led by Barbara Philips, entitled “Upper airway surgery does not have a major role in the treatment of sleep apnea.”[2]
Nelson Powell provided the Pro side - Upper airway surgery does have a major role in the treatment of obstructive sleep apnea "the tail end of the dog".[3]
Both sides had tremendous points, and their veracity in respective contexts rings true to this day. I have come to realize that growth in medical fields can evolve through an adversarial stage. When well-intentioned, the fights come from each side believing intensely in their experience. At some point, circumstances coalesce, and experts begin working together.
In finishing an update to a textbook chapter where an upper airway surgery algorithm is merged with a CPAP treatment pathway, I am grateful to pioneers of the field. I am also grateful to medical colleagues who have championed cross-disciplinary collaboration.
Today, new debates have emerged with OSA, dentofacial growth, and myofunctional physiology. I look forward to our era’s fair, professional, and peer-reviewed debates.
The Pro side from me: Seeing (and treating) anatomic contributors of OSA as restoring missed milestones in facial and airway growth.
More than an academic point of view, it turns out that restoration of missed milestones is also applicable to one’s career.
References
1. Hendershott, A., The politics of envy. 2020, Manchester: Crisis Publications. pages cm. Envy of Excellence in Academe. p.195-240.
2. Phillips, B., Upper airway surgery does not have a major role in the treatment of sleep apnea. Con. J Clin Sleep Med, 2005. 1(3): p. 241-5.
3. Powell, N., Upper airway surgery does have a major role in the treatment of obstructive sleep apnea "the tail end of the dog". Pro. J Clin Sleep Med, 2005. 1(3): p. 236-40.
