In the Media

The Global Initiative for Obstructive Sleep Apnea (GIFOSA) has published its founding paper in Pulmonary Therapy, with 44 authors from 23 countries. Professor Sy Duong-Quy conceived and leads the initiative, and Dr. Clete Kushida is senior author. Dr. Liu contributed the surgical section and serves as Deputy President for Intervention.

The framework places surgery within the care continuum, alongside medical management. Nasal surgery improves PAP adherence. Treatment selection follows functional anatomic phenotyping and drug-induced sleep endoscopy within the updated Stanford (Riley-Powell-Liu) protocol, and the paper names the contemporary options: distraction osteogenesis maxillary expansion (DOME), tissue-preserving palatopharyngoplasty, maxillomandibular advancement, and hypoglossal nerve stimulation in selected refractory cases.

In children, early intervention optimizes facial and airway development. Maxillary expansion with myofunctional therapy is often helpful when adenotonsillectomy alone is inadequate, and craniofacial growth modification may represent a preventive intervention for adult OSA.

Restoring Sleep Breathing Health as the Gateway to Wellness.

Several years ago, Dr. Liu and Dr. Corissa Chang reported a consistent pattern: for the same degree of daytime sleepiness and fatigue, women present with a lower mean apnea-hypopnea index (AHI). In other words, the metric used to grade sleep-disordered breathing (SDB)/OSA severity underestimates disease burden in women.

Clinicians continue to apply identical thresholds, developed around the physiology and risk profile of an overweight middle-aged man, to a recent college-graduate woman. How can that be right? The clinical consequences are predictable. For similar complaints, women are three times more likely to be labeled with anxiety or depression and started on psychoactive medications, rather than receiving an equally thorough evaluation for SDB/OSA. This mismatch is especially harmful in upper airway resistance syndrome (UARS).

"We cannot change diagnostic parameters overnight, but we can change our practice today," says Dr. Liu. "As surgeons who manage SDB/OSA, we can recalibrate our index of suspicion in women, and prioritize symptom-weighted evaluation over AHI alone. Integrating arousal-based metrics, nasal and craniofacial contributors, and functional anatomy into our decision-making is essential to close this gap in women's sleep health."

Restoring Sleep Breathing Health as the Gateway to Wellness.

Earlier this year, Dr. Liu met Dr. Jeanette Chua in Kuala Lumpur and came away inspired by her vision of "Unified Dentistry."

Dr. Bill Dement wrote in his book that "Before 1970, medicine stopped when the patient went to sleep." The same can be said about oral health today, but change is underway.

"This is an exciting era to optimize bite, breathing, and beauty on a global scale. Let's do it together," says Dr. Liu.

"Comparative Efficacy of Obstructive Sleep Apnea Patients Undergoing Multilevel Surgery Followed by Upper Airway Stimulation Versus Isolated Upper Airway Stimulation"

The OMS Foundation Dr. David Stanton Resident Research Award recognizes the author of the most outstanding resident research paper published in the Journal of Oral and Maxillofacial Surgery during the previous year. The 2024 award recipient Dr. Corissa Chang along with Dr. Stanley Liu discuss the winning research. AAOMS On the Go Podcast.