International expert consensus statement: surgical failure in obstructive sleep apnea.

Clinical guidelines Delphi method Expert consensus Obstructive sleep apnea Sleep disorder management

Journal

Sleep & breathing = Schlaf & Atmung

ISSN: 1522-1709

Titre abrégé: Sleep Breath

Pays: Germany

ID NLM: 9804161

Informations de publication

Date de publication:
23 Sep 2024

Historique:

received: 27 05 2024

accepted: 06 09 2024

revised: 26 08 2024

medline: 23 9 2024

pubmed: 23 9 2024

entrez: 22 9 2024

Statut: aheadofprint

Résumé

Upper airway (UA) surgery is commonly employed in the treatment of patients with obstructive sleep apnea (OSA). The intricate pathophysiology of OSA, variability in sites and patterns of UA collapse, and the interaction between anatomical and non-anatomical factors in individual patients may contribute to possible surgical failures. This clinical consensus statement aims to identify areas of agreement among a development group comprising international experts in OSA surgery, regarding the appropriate definition, predictive factors in patients, and management of surgical failure in OSA treatment. A clinical consensus statement (CCS) was developed using the Delphi method by a panel of 35 contributors from various countries. A systematic literature review adhering to PRISMA guidelines was conducted. A survey consisting of 60 statements was then formulated and presented to the experts. Following two rounds of the Delphi process, consensus or strong consensus was achieved on 36 items, while 24 items remained without consensus. Specifically, 5 out of 10 statements reached consensus regarding on the 'Definition of Surgical Success/Failure after OSA Surgery'. Regarding the 'Predictive Factors of Surgical Failure in OSA Surgery', consensus was reached on 10 out of 13 statements. In the context of the 'Diagnostic Workup in OSA Surgery', consensus was achieved on 9 out of 13 statements. Lastly, in 'Treatment in Surgical Failure Cases', consensus was reached on 12 out of 24 statements. The management of OSA after surgical failure presents a significant clinical challenge for sleep specialists. This CCS provides valuable guidance for defining, preventing, and addressing surgical failures in the treatment of OSA syndrome.

Identifiants

DOI: 10.1007/s11325-024-03162-6 PMID: 39307877

pubmed: 39307877

doi: 10.1007/s11325-024-03162-6

pii: 10.1007/s11325-024-03162-6

doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

Informations de copyright

Références

Iannella G, Magliulo G, Lo Iacono CAM et al (2022) Quality of life and excessive daytime sleepiness in adults with obstructive sleep apnea who are treated with multilevel surgery or adherent to continuous positive airway pressure. J Clin Med 11(9):2375

pubmed: 35566499 pmcid: 9103957 doi: 10.3390/jcm11092375

Ulualp SO, Kezirian EJ (2024) Advanced diagnostic techniques in obstructive sleep apnea. Otolaryngol Clin North Am S0030–6665(24):00033–00041. https://doi.org/10.1016/j.otc.2024.02.020

doi: 10.1016/j.otc.2024.02.020

Malhotra A, White DP (2002) Obstructive sleep apnoea. Lancet 360(9328):237–245

pubmed: 12133673 doi: 10.1016/S0140-6736(02)09464-3

Myers KA, Mrkobrada M, Simel DL (2013) Does this patient have obstructive sleep apnea? The rational clinical examination systematic review. JAMA 310(7):731–741

pubmed: 23989984 doi: 10.1001/jama.2013.276185

Wickwire EM, Albrecht JS (2024) Occult, undiagnosed obstructive sleep apnea is associated with increased health care resource utilization and costs among older adults with comorbid depression: a retrospective cohort study among Medicare beneficiaries. J Clin Sleep Med. https://doi.org/10.5664/jcsm.10956

Abourjeili J, Salameh E, Noureddine M, Bou Khalil P, Eid AA (2024) Obstructive sleep apnea: beyond the dogma of obesity! Respir Med 222:107512

pubmed: 38158138 doi: 10.1016/j.rmed.2023.107512

Vgontzas AN, He F, Fernandez-Mendoza J et al (2024) Age-related differences in the association of mild-to-moderate sleep apnea with incident cardiovascular and cerebrovascular diseases. Sleep Med 113:306–312

pubmed: 38101102 doi: 10.1016/j.sleep.2023.11.1133

Iannella G, Magliulo G, De Vito A, Vicini C (2019) In response to the “Letter to the editor” on the paper “aging effect on sleepiness and apneas severity in patients with obstructive sleep apnea syndrome: a meta-analysis study.” Eur Arch Otorhinolaryngol 276(12):3559–3560

pubmed: 31584116 doi: 10.1007/s00405-019-05673-5

Jordan AS, McSharry DG, Malhotra A (2014) Adult obstructive sleep apnoea. Lancet 383(9918):736–747

pubmed: 23910433 doi: 10.1016/S0140-6736(13)60734-5

Kent BD, Ryan S, McNicholas WT (2011) Obstructive sleep apnea and inflammation: relationship to cardiovascular co-morbidity. Respir Physiol Neurobiol 178(3):475–481

pubmed: 21439407 doi: 10.1016/j.resp.2011.03.015

Vicini C, De Vito A, Iannella G et al (2018) The aging effect on upper airways collapse of patients with obstructive sleep apnea syndrome. Eur Arch Otorhinolaryngol 275(12):2983–2990

pubmed: 30317385 doi: 10.1007/s00405-018-5163-5

Sabil A, Gagnadoux F (2023) Obstructive sleep apnoea, nocturnal hypoxaemia, and cognitive decline in elderly patients. Eur Respir J 61(4):2300300

pubmed: 37105589 doi: 10.1183/13993003.00300-2023

Dibra MN, Berry RB, Wagner MH (2017) Treatment of obstructive sleep apnea: choosing the best interface. Sleep Med Clin 12(4):543–549

pubmed: 29108609 doi: 10.1016/j.jsmc.2017.07.004

Billings KR, Maddalozzo J (2023) Integrative approach to managing obstructive sleep apnea. Sleep Med Clin 18(3):269–275

pubmed: 37532368 doi: 10.1016/j.jsmc.2023.05.011

Billings KR, Maddalozzo J (2022) Integrative approach to managing obstructive sleep apnea. Otolaryngol Clin North Am 55(5):1045–1054

pubmed: 36088151 doi: 10.1016/j.otc.2022.06.010

Baldassari CM, Choi S (2018) Mild obstructive sleep apnea in children: what is the best management option? Laryngoscope 128(12):2671–2672

pubmed: 29521427 doi: 10.1002/lary.27157

Batool-Anwar S, Goodwin JL, Kushida CA et al (2016) Impact of continuous positive airway pressure (CPAP) on quality of life in patients with obstructive sleep apnea (OSA). J Sleep Res 25(6):731–738

pubmed: 27242272 pmcid: 5436801 doi: 10.1111/jsr.12430

Mehrtash M, Bakker JP, Ayas N (2019) Predictors of continuous positive airway pressure adherence in patients with obstructive sleep apnea. Lung 197(2):115–121

pubmed: 30617618 doi: 10.1007/s00408-018-00193-1

Gottlieb DJ, Punjabi NM (2020) Diagnosis and management of obstructive sleep apnea: a review. JAMA 323(14):1389–1400

pubmed: 32286648 doi: 10.1001/jama.2020.3514

Li HY (2019) Palatal surgery for obstructive sleep apnea: from ablation to reconstruction. Sleep Med Clin 14(1):51–58

pubmed: 30709533 doi: 10.1016/j.jsmc.2018.10.006

Dicus Brookes CC, Boyd SB (2017) Controversies in obstructive sleep apnea surgery. Oral Maxillofac Surg Clin North Am 29(4):503–513

pubmed: 28987230 doi: 10.1016/j.coms.2017.07.005

Iannella G, Magliulo G, Cammaroto G et al (2022) Effectiveness of drug-induced sleep endoscopy in improving outcomes of barbed pharyngoplasty for obstructive sleep apnea surgery: a prospective randomized trial. Sleep Breath 26(4):1621–1632. https://doi.org/10.1007/s11325-021-02528-4

doi: 10.1007/s11325-021-02528-4 pubmed: 34802107

Nunes HDSS, Vaz de Castro J, Favier V, el at, (2023) Predictors of success of pharyngeal surgery in the treatment of obstructive sleep apnea: a narrative review. J Clin Med 12(21):6773

pubmed: 37959237 pmcid: 10649816 doi: 10.3390/jcm12216773

Cammaroto G, Stringa LM, Iannella G et al (2020) Manipulation of lateral pharyngeal wall muscles in sleep surgery: a review of the literature. Int J Environ Res Public Health 17(15):5315

pubmed: 32718065 pmcid: 7432019 doi: 10.3390/ijerph17155315

De Vito A, Woodson BT, Koka V et al (2021) OSA upper airways surgery: a targeted approach. Medicina (Kaunas) 57(7):690

pubmed: 34356971 doi: 10.3390/medicina57070690

Bosi M, De Vito A, Eckert D et al (2020) Qualitative phenotyping of obstructive sleep apnea and its clinical usefulness for the sleep specialist. Int J Environ Res Public Health 17(6):2058

pubmed: 32244892 pmcid: 7143772 doi: 10.3390/ijerph17062058

Rosenfeld RM, Nnacheta LC, Corrigan MD (2015) Clinical consensus statement development manual. Otolaryngol Head Neck Surg 153(2 Suppl):S1–S14

pubmed: 26527615

Bosi M, De Vito A, Kotecha B et al (2018) Phenotyping the pathophysiology of obstructive sleep apnea using polygraphy/polysomnography: a review of the literature. Sleep Breath 22(3):579–592

pubmed: 29318567 doi: 10.1007/s11325-017-1613-3

Pang KP, Rotenberg BW (2014) Redefining successful therapy in obstructive sleep apnea: a call to arms. Laryngoscope 124(5):1051–1052. https://doi.org/10.1002/lary.24628

doi: 10.1002/lary.24628 pubmed: 24482197

Iannella G, Magliulo G, Greco A et al (2024) Clinical application of pediatric sleep endoscopy: an international survey. Children (Basel) 11(1):94

pubmed: 38255407

Edwards BA, Wellman A, Sands SA et al (2014) Obstructive sleep apnea in older adults is a distinctly different physiological phenotype. Sleep 37(7):1227–1236

pubmed: 25061251 pmcid: 4098808 doi: 10.5665/sleep.3844

Pang KP, Vicini C, Montevecchi F et al (2020) Long-term complications of palate surgery: a multicenter study of 217 patients. Laryngoscope 130(9):2281–2284

pubmed: 31765026 doi: 10.1002/lary.28432

Pang KP, Baptista PM, Olszewska E et al (2020) SLEEP-GOAL: A multicenter success criteria outcome study on 302 obstructive sleep apnoea (OSA) patients. Med J Malaysia 75(2):117–123

pubmed: 32281591

Han F, Song W, Li J, Zhang L, Dong X, He Q (2006) Influence of UPPP surgery on tolerance to subsequent continuous positive airway pressure in patients with OSAHS. Sleep Breath 10(1):37–42

pubmed: 16432757 doi: 10.1007/s11325-005-0041-y

Chandrashekariah R, Shaman Z, Auckley D (2008) Impact of upper airway surgery on CPAP compliance in difficult-to-manage obstructive sleep apnea. Arch Otolaryngol Head Neck Surg 134(9):926–930. https://doi.org/10.1001/archotol.1sleep.9.926

doi: 10.1001/archotol.1sleep.9.926 pubmed: 18794435

Stilo G, Vicini C, Pollicina I et al (2023) Is continuous positive airway pressure a valid alternative to sildenafil in treating sexual dysfunction among OSA patients? A systematic review and meta-analysis. Medicina (Kaunas) 59(7):1318

pubmed: 37512129 doi: 10.3390/medicina59071318

Ayers CM, Lohia S, Nguyen SA, Gillespie MB (2016) The effect of upper airway surgery on continuous positive airway pressure levels and adherence: a systematic review and meta-analysis. ORL J Otorhinolaryngol Relat Spec 78(3):119–125

pubmed: 27050814 doi: 10.1159/000442023

Iannella G, Magliulo G, Di Luca M et al (2020) Lateral pharyngoplasty techniques for obstructive sleep apnea syndrome: a comparative experimental stress test of two different techniques. Eur Arch Otorhinolaryngol 277(6):1793–1800

pubmed: 32144568 doi: 10.1007/s00405-020-05883-2

Luzzi V, Altieri F, Guaragna M et al (2023) Friedman tongue position and the anthropometric parameters in adult patients with obstructive sleep apnea: an observational study. Int J Environ Res Public Health 20(4):3255

pubmed: 36833949 pmcid: 9960801 doi: 10.3390/ijerph20043255

Maniaci A, Riela PM, Iannella G et al (2023) Machine learning identification of obstructive sleep apnea severity through the patient clinical features: a retrospective study. Life (Basel) 13(3):702

pubmed: 36983857

Iannella G, Vallicelli B, Magliulo G et al (2020) Long-term subjective outcomes of barbed reposition pharyngoplasty for obstructive sleep apnea syndrome treatment. Int J Environ Res Public Health 17(5):1542

pubmed: 32121007 pmcid: 7084807 doi: 10.3390/ijerph17051542

Kim JY, Kong HJ, Kim SH et al (2021) Machine learning-based preoperative datamining can predict the therapeutic outcome of sleep surgery in OSA subjects. Sci Rep 11(1):14911

pubmed: 34290326 pmcid: 8295249 doi: 10.1038/s41598-021-94454-4

Cammaroto G, Bettini P, Meccariello G et al (2024) Barbed repositioning pharyngoplasty: tips and tricks. Otolaryngol Head Neck Surg 170(4):1204–1207

pubmed: 38104315 doi: 10.1002/ohn.626

Bahgat A, Alkan U, Carrasco Ilatas M et al (2023) International palate surgery questionnaire. Sleep Breath 27(2):569–590

pubmed: 35708878 doi: 10.1007/s11325-022-02631-0

pubmed: 34802107 doi: 10.1007/s11325-021-02528-4

Epstein LJ, Kristo D, Strollo PJ Jr et al (2009) Adult obstructive sleep apnea task force of the American academy of sleep medicine. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med 5(3):263–76

Arachchige MA, Steier J (2022) Beyond usual care: a multidisciplinary approach towards the treatment of obstructive sleep apnoea. Front Cardiovasc Med 5(8):747495

doi: 10.3389/fcvm.2021.747495

Vicini C, Cammaroto G (2023) Treatment of sleep disordered breathing relapse after surgery. Acta Otorhinolaryngol Ital 43(Suppl 1):S103–S110

pubmed: 37698107 pmcid: 10159645 doi: 10.14639/0392-100X-suppl.1-43-2023-13

Moffa A, Giorgi L, Cassano M, Lugo R, Baptista P, Casale M (2023) Complications and side effects after barbed pharyngoplasty: a systematic review. Sleep Breath 27(1):31–38

pubmed: 35217931 doi: 10.1007/s11325-022-02585-3

Eplite A, Vicini C, Meccariello G et al (2023) Multi-level 3D surgery for obstructive sleep apnea: could it be the future? J Clin Med 12(13):4173

pubmed: 37445208 pmcid: 10342675 doi: 10.3390/jcm12134173

Gulotta G, Iannella G, Meccariello G et al (2021) Barbed suture Extrusion and Exposure in palatoplasty for OSA: What does it mean? Am J Otolaryngol 42(4):102994

pubmed: 33639448 doi: 10.1016/j.amjoto.2021.102994

Chang JL, Goldberg AN, Alt JA et al (2023) International consensus statement on obstructive sleep apnea. Int Forum Allergy Rhinol 13(7):1061–1482

pubmed: 36068685 pmcid: 10359192 doi: 10.1002/alr.23079

Al Oweidat K, Toubasi AA, Al-Iede M, Hasuneh MM, Al-Sayegh TN (2023) Comparing the diagnostic value of the positional obstructive sleep apnea definitions. Respir Med 212:107227

pubmed: 37004754 doi: 10.1016/j.rmed.2023.107227

Iannella G, Magliulo G, Lo Iacono CAM et al (2020) Positional obstructive sleep apnea syndrome in elderly patients. Int J Environ Res Public Health 17(3):1120

pubmed: 32050596 pmcid: 7042812 doi: 10.3390/ijerph17031120

Cammaroto G, Moretti C, Di Prinzio G et al (2022) The effects of barbed repositioning pharyngoplasty in positional and non-positional OSA patients: a retrospective analysis. J Clin Med 11(22):6749

pubmed: 36431226 pmcid: 9697864 doi: 10.3390/jcm11226749

Akashiba T, Inoue Y, Uchimura N et al (2022) Sleep apnea syndrome (SAS) clinical practice guidelines 2020. Respir Investig 60(1):3–32

pubmed: 34986992 doi: 10.1016/j.resinv.2021.08.010

Chen RF, Nakayama M, Sung WC, Hung JF, Chu YM (2022) Comparison of surgical outcomes of sleep surgeries preoperatively evaluated with drug-induced sleep endoscopy and Müller’s maneuver. Auris Nasus Larynx 49(2):235–239

pubmed: 34454780 doi: 10.1016/j.anl.2021.08.001

Eckert DJ, White DP, Jordan AS, Malhotra A, Wellman A (2013) Defining phenotypic causes of obstructive sleep apnea. Identification of novel therapeutic targets. Am J Respir Crit Care Med 188(8):996–1004

pubmed: 23721582 pmcid: 3826282 doi: 10.1164/rccm.201303-0448OC

Maniaci A, Di Luca M, Lechien JR et al (2022) Lateral pharyngoplasty vs. traditional uvulopalatopharyngoplasty for patients with OSA: systematic review and meta-analysis. Sleep Breath 26(4):1539–1550

pubmed: 34978022 doi: 10.1007/s11325-021-02520-y

Vicini C, Meccariello G, Montevecchi F et al (2020) Effectiveness of barbed repositioning pharyngoplasty for the treatment of obstructive sleep apnea (OSA): a prospective randomized trial. Sleep Breath 24(2):687–694

pubmed: 31786746 doi: 10.1007/s11325-019-01956-7

Iannella G, Magliulo G, Maniaci A et al (2021) Olfactory function in patients with obstructive sleep apnea: a meta-analysis study. Eur Arch Otorhinolaryngol 278(3):883–891

pubmed: 32914257 doi: 10.1007/s00405-020-06316-w

Millman RP, Rosenberg CL, Carlisle CC, Kramer NR, Kahn DM, Bonitati AE (1998) The efficacy of oral appliances in the treatment of persistent sleep apnea after uvulopalatopharyngoplasty. Chest 113(4):992–996

pubmed: 9554637 doi: 10.1378/chest.113.4.992

Hoffstein V (2007) Review of oral appliances for treatment of sleep-disordered breathing. Sleep Breath 11(1):1–22

pubmed: 17136406 doi: 10.1007/s11325-006-0084-8

Iannella G, Cammaroto G, Meccariello G et al (2022) Head-Of-bed elevation (HOBE) for improving positional obstructive sleep apnea (POSA): an experimental study. J Clin Med 11(19):5620

pubmed: 36233488 pmcid: 9571825 doi: 10.3390/jcm11195620

Koka V, De Vito A, Roisman G et al (2021) Orofacial myofunctional therapy in obstructive sleep apnea syndrome: a pathophysiological perspective. Medicina (Kaunas) 57(4):323

pubmed: 33915707 doi: 10.3390/medicina57040323

Camacho M, Certal V, Abdullatif J et al (2015) Myofunctional therapy to treat obstructive sleep apnea: a systematic review and meta-analysis. Sleep 38(5):669–675

pubmed: 25348130 pmcid: 4402674 doi: 10.5665/sleep.4652

Yu JL, Thaler ER (2020) Hypoglossal nerve (Cranial Nerve XII) stimulation. Otolaryngol Clin North Am 53(1):157–169

pubmed: 31699408 doi: 10.1016/j.otc.2019.09.010

Lechien JR, Chiesa-Estomba CM, Fakhry N et al (2021) Surgical, clinical, and functional outcomes of transoral robotic surgery used in sleep surgery for obstructive sleep apnea syndrome: a systematic review and meta-analysis. Head Neck 43:2216–2239

pubmed: 33860981 doi: 10.1002/hed.26702