MacKay S, Carney AS, Catcheside PG, et al. - This multicenter, parallel-group, open-label randomized clinical trial was undertaken to determine if combined palatal and tongue surgery to enlarge or stabilize the upper airway is an effective treatment for patients with obstructive sleep apnea (OSA) when conventional device treatment failed. Of the 102 candidates who were randomized (mean [SD] age, 44.6 [12.8] years; 18 [18%] women), 91 (89%) completed the trial. Combined palatal and tongue surgery relative to medical management lessened the number of apnea and hypopnea events and patient-reported sleepiness at 6 months in this preliminary study of adults with moderate or severe OSA in whom conventional therapy had failed. Further research is required to confirm such findings in additional populations and to understand clinical utility, long-term effectiveness, and safety of multilevel upper airway surgery for treatment of patients with OSA.