Predictors of success in hypoglossal nerve stimulator implantation for obstructive sleep apnea.
Drug-induced sleep endoscopy
Hypoglossal nerve stimulator
Obstructive sleep apnea
Predictor
Treatment
Journal
World journal of otorhinolaryngology - head and neck surgery
ISSN: 2589-1081
Titre abrégé: World J Otorhinolaryngol Head Neck Surg
Pays: United States
ID NLM: 101690857
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
28
08
2019
revised:
21
01
2020
accepted:
16
02
2020
entrez:
21
1
2021
pubmed:
22
1
2021
medline:
22
1
2021
Statut:
epublish
Résumé
Current guidelines for hypoglossal nerve stimulator (HGNS) implantation eligibility include drug-induced sleep endoscopy (DISE) findings and other patient characteristics but lead to highly variable rates of surgical success across institutions. Our objective was to determine whether additional factors seen on preoperative evaluation could be used as predictors of surgical success. Retrospective chart review. Single-institution academic tertiary care medical center. and Methods:This study included patients with obstructive sleep apnea (OSA) who underwent HGNS implantation between 2015 and 2018. Surgical success was defined as a postoperative apnea-hypopnea index (AHI) of less than 20 events per hour and an AHI reduction of at least 50%. Preoperative polysomnogram (PSG) results, DISE findings, and physical parameters were compared between surgical successes and failures. A total of 68 patients were included in the analysis. The overall surgical success rate was 79.4% (54/68). Elevated preoperative AHI was associated with an increased likelihood of treatment failure, with an AHI of (36.9 ± 16.8) events/hour in the success group compared to (49.4 ± 19.6) events/hour in the failure group ( Patients who underwent HGNS implantation overall had a very high treatment response rate at our institution. Factors that may predispose patients to surgical failure included the presence of lateral oropharyngeal collapse and a significantly elevated preoperative AHI. These should be considered when determining surgical candidacy for HGNS implantation.
Identifiants
pubmed: 33474543
doi: 10.1016/j.wjorl.2020.02.007
pii: S2095-8811(20)30074-3
pmc: PMC7801256
doi:
Types de publication
Journal Article
Langues
eng
Pagination
40-44Informations de copyright
© 2020 The Authors.
Déclaration de conflit d'intérêts
The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Tiffany Chao; No conflicts of interest to disclose. Erica Thaler; Previous research funding from Inspire Medical Systems. Participation in ADHERE study funded by Inspire Medical Systems.
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