Purpose: To evaluate differential surgical interventions for obstructive sleep apnea (OSA) patients with single-level retropalatal based on the preoperative topographical diagnosis using naso-endoscopy with Müller’s maneuver during supine position (MM-P). Subjects and Methods: This case series included adult patients with OSA who showed a predominant single level retro-palatal collapse on MM-P. An anteroposterior pattern of collapse was managed by an anterior advancement procedure, while a transverse pattern of collapse was managed by lateral/antero-lateral advancement procedures (double suspension sutures). A combined procedure was provided to the concentric type of collapse. All patients underwent evaluation of the polysomnography, Epworth Sleepiness Scale (ESS) values and snoring scores both preoperatively and 6-8 months after surgery. Results: Among 102 patients, the most commonly reported pattern of collapse at the retro-palatal level was the concentric pattern (48.04%) followed by the transverse pattern (27.45%). The AP- pattern of collapse was reported in 24.51%. In the postoperative follow up visits, no early or late complications were reported. All included groups showed significant improvement in polysomnographic data (mean AHI and lowest O2 saturation level). Significant improvement of VAS of snoring was reported. The overall success rate was ˃90%. Conclusion: Preoperative differential diagnosis of OSA with MM-P allows for tailored surgical management. Tailored procedures could yield good surgical outcomes when patients are properly selected and the technique is chosen according to preoperative topographical diagnostic assessment. This study might provide an available less-costly and effective preoperative planning for OSA intervention.