Hypoglossal Nerve Stimulation in the Treatment of Obstructive Sleep Apnea: Patient Selection and New Perspectives

Peter M Baptista,1 Andrea Costantino,2 Antonio Moffa,3,4 Vittorio Rinaldi,3 Manuele Casale3 1Department of ORL, Clínica Universidad de Navarra, Pamplona, Spain; 2Otorhinolaryngology Unit, Humanitas Clinical and Research Center-IRCCS, Milan, Italy; 3Department of Otolaryngology, Integrated...

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Autores principales:	Baptista PM, Costantino A, Moffa A, Rinaldi V, Casale M
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	obstructive sleep apnea hypoglossal nerve upper airway stimulation personalized medicine. Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
Acceso en línea:	https://doaj.org/article/09202b6e1a064865b4061c54fc761b79
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spelling	oai:doaj.org-article:09202b6e1a064865b4061c54fc761b792021-12-02T04:42:15ZHypoglossal Nerve Stimulation in the Treatment of Obstructive Sleep Apnea: Patient Selection and New Perspectives1179-1608https://doaj.org/article/09202b6e1a064865b4061c54fc761b792020-02-01T00:00:00Zhttps://www.dovepress.com/hypoglossal-nerve-stimulation-in-the-treatment-of-obstructive-sleep-ap-peer-reviewed-article-NSShttps://doaj.org/toc/1179-1608Peter M Baptista,1 Andrea Costantino,2 Antonio Moffa,3,4 Vittorio Rinaldi,3 Manuele Casale3 1Department of ORL, Clínica Universidad de Navarra, Pamplona, Spain; 2Otorhinolaryngology Unit, Humanitas Clinical and Research Center-IRCCS, Milan, Italy; 3Department of Otolaryngology, Integrated Therapies in Otolaryngology, University Campus Bio-Medico, Rome, Italy; 4Department of Otolaryngology, University of Foggia, Foggia, ItalyCorrespondence: Peter M BaptistaDepartment of ORL, Clinica Universidad de Navarra, Pamplona, SpainEmail pmbaptista@unav.esAbstract: Hypoglossal nerve stimulation (HNS) is an increasingly widespread OSA treatment. It is a non-anatomical modifying surgery able to achieve an adequate objective and subjective result with a reasonable complication rate. HNS exploits the neurostimulation to reduce upper airway collapsibility providing a multilevel upper airway improvement within a single procedure. Proper patient selection has a fundamental role in determining an adequate long-term clinical outcome. All patient candidates for HNS undergo a standard comprehensive sleep medicine assessment and upper airway surgical examination. Several features should be assessed preoperatively in order to predict patients’ response to HNS treatment. In particular, the assessment of OSA severity, BMI > 32 Kg/m2, collapse pattern during drug-induced sleep endoscopy (DISE), and many other parameters, is central for a good patient selection and customization of OSA treatment. HNS is indeed one of the most promising tools in the widespread context of personalized sleep medicine. HNS is an adjustable medical device that could be titrated in order to improve HNS effectiveness, maintaining patient comfort. Moreover, HNS provides the opportunity for patients to play an active role in their own care, with a potential improvement in therapy adherence and efficacy. This review summarizes the current evidence in patient selection for HNS, highlighting the reasons behind the optimistic future of this OSA treatment in the context of personalized medicine.Keywords: obstructive sleep apnea, hypoglossal nerve, upper airway, stimulation, personalized medicineBaptista PMCostantino AMoffa ARinaldi VCasale MDove Medical Pressarticleobstructive sleep apneahypoglossal nerveupper airwaystimulationpersonalized medicine.PsychiatryRC435-571Neurophysiology and neuropsychologyQP351-495ENNature and Science of Sleep, Vol Volume 12, Pp 151-159 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	obstructive sleep apnea hypoglossal nerve upper airway stimulation personalized medicine. Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
spellingShingle	obstructive sleep apnea hypoglossal nerve upper airway stimulation personalized medicine. Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495 Baptista PM Costantino A Moffa A Rinaldi V Casale M Hypoglossal Nerve Stimulation in the Treatment of Obstructive Sleep Apnea: Patient Selection and New Perspectives
description	Peter M Baptista,1 Andrea Costantino,2 Antonio Moffa,3,4 Vittorio Rinaldi,3 Manuele Casale3 1Department of ORL, Clínica Universidad de Navarra, Pamplona, Spain; 2Otorhinolaryngology Unit, Humanitas Clinical and Research Center-IRCCS, Milan, Italy; 3Department of Otolaryngology, Integrated Therapies in Otolaryngology, University Campus Bio-Medico, Rome, Italy; 4Department of Otolaryngology, University of Foggia, Foggia, ItalyCorrespondence: Peter M BaptistaDepartment of ORL, Clinica Universidad de Navarra, Pamplona, SpainEmail pmbaptista@unav.esAbstract: Hypoglossal nerve stimulation (HNS) is an increasingly widespread OSA treatment. It is a non-anatomical modifying surgery able to achieve an adequate objective and subjective result with a reasonable complication rate. HNS exploits the neurostimulation to reduce upper airway collapsibility providing a multilevel upper airway improvement within a single procedure. Proper patient selection has a fundamental role in determining an adequate long-term clinical outcome. All patient candidates for HNS undergo a standard comprehensive sleep medicine assessment and upper airway surgical examination. Several features should be assessed preoperatively in order to predict patients’ response to HNS treatment. In particular, the assessment of OSA severity, BMI > 32 Kg/m2, collapse pattern during drug-induced sleep endoscopy (DISE), and many other parameters, is central for a good patient selection and customization of OSA treatment. HNS is indeed one of the most promising tools in the widespread context of personalized sleep medicine. HNS is an adjustable medical device that could be titrated in order to improve HNS effectiveness, maintaining patient comfort. Moreover, HNS provides the opportunity for patients to play an active role in their own care, with a potential improvement in therapy adherence and efficacy. This review summarizes the current evidence in patient selection for HNS, highlighting the reasons behind the optimistic future of this OSA treatment in the context of personalized medicine.Keywords: obstructive sleep apnea, hypoglossal nerve, upper airway, stimulation, personalized medicine
format	article
author	Baptista PM Costantino A Moffa A Rinaldi V Casale M
author_facet	Baptista PM Costantino A Moffa A Rinaldi V Casale M
author_sort	Baptista PM
title	Hypoglossal Nerve Stimulation in the Treatment of Obstructive Sleep Apnea: Patient Selection and New Perspectives
title_short	Hypoglossal Nerve Stimulation in the Treatment of Obstructive Sleep Apnea: Patient Selection and New Perspectives
title_full	Hypoglossal Nerve Stimulation in the Treatment of Obstructive Sleep Apnea: Patient Selection and New Perspectives
title_fullStr	Hypoglossal Nerve Stimulation in the Treatment of Obstructive Sleep Apnea: Patient Selection and New Perspectives
title_full_unstemmed	Hypoglossal Nerve Stimulation in the Treatment of Obstructive Sleep Apnea: Patient Selection and New Perspectives
title_sort	hypoglossal nerve stimulation in the treatment of obstructive sleep apnea: patient selection and new perspectives
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/09202b6e1a064865b4061c54fc761b79
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Hypoglossal Nerve Stimulation in the Treatment of Obstructive Sleep Apnea: Patient Selection and New Perspectives

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