목적: The present study investigated whether DISE and cephalometric measurements could predict the therapeutic outcome of multilevel surgery for patients with obstructive sleep apnea (OSA). 방법:This study was designed as retrospectively reviews of the patients who underwent multilevel sleep surgery. The operations were performed based on preoperative evaluation and intraoperative DISE findings. Data were collected involving demographic data, pre- and postoperative polysomnography, cephalometric parameters, and DISE findings which were taken intraoperatively. The patients were divided into 2 groups according to the degree of change in the AHI pre- and 6 months postoperatively good outcome group (50% decrease in AHI) and poor outcome group (less than 50% decrease or increase in AHI). The various cephalometric parameters were measured, and DISE findings were classified as Vote and Fujita classification. 결과:Total 33 patients were involved, mean age was 44.8 years. The number of good outcome group was 19 (58%) and poor outcome group was 14 (42%). Good outcome group had significantly lower MPH in cephalometry (p=0.035) and higher preoperative AHI (p=0.006) than poor outcome group. In terms of DISE findings, hypopharynx shape (Fujita classification) were correlated with treatment outcome significantly (p=0.037), but Vote classification didnt represent the treatment outcome. The remarkable finding was that uvula fluttering shown in DISE was a significant predictor of treatment outcome (p=0.035). 결론:Preoperative MPH on cephalometric measurements could be a predictor of the therapeutic response to the multilevel surgery in patients with OSAS. Furthermore, uvula fluttering could also be a significant predictor of surgical outcome. This study might contribute to the selection of the surgical candidate for OSAS and modification of classification of the DISE findings.