Predictors of success in hypoglossal nerve stimulator implantation for obstructive sleep apnea

Objective: 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 addi...

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Autores principales:	Tiffany N. Chao, Erica R. Thaler
Formato:	article
Lenguaje:	EN
Publicado:	KeAi Communications Co., Ltd. 2021
Materias:	Obstructive sleep apnea Hypoglossal nerve stimulator Drug-induced sleep endoscopy Treatment Predictor Otorhinolaryngology RF1-547 Surgery RD1-811
Acceso en línea:	https://doaj.org/article/797ec2f06cec4361ae5ddcc67533e656
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spelling	oai:doaj.org-article:797ec2f06cec4361ae5ddcc67533e6562021-12-02T13:57:41ZPredictors of success in hypoglossal nerve stimulator implantation for obstructive sleep apnea2095-881110.1016/j.wjorl.2020.02.007https://doaj.org/article/797ec2f06cec4361ae5ddcc67533e6562021-01-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2095881120300743https://doaj.org/toc/2095-8811Objective: 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. Study design: Retrospective chart review. Setting: Single-institution academic tertiary care medical center. Subjects: 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. Results: 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 (P = 0.05). Patients observed to have partial lateral oropharyngeal collapse on DISE was more frequently associated with the treatment failure group than in the success group (P = 0.04). Conclusion: 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.Tiffany N. ChaoErica R. ThalerKeAi Communications Co., Ltd.articleObstructive sleep apneaHypoglossal nerve stimulatorDrug-induced sleep endoscopyTreatmentPredictorOtorhinolaryngologyRF1-547SurgeryRD1-811ENWorld Journal of Otorhinolaryngology-Head and Neck Surgery, Vol 7, Iss 1, Pp 40-44 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Obstructive sleep apnea Hypoglossal nerve stimulator Drug-induced sleep endoscopy Treatment Predictor Otorhinolaryngology RF1-547 Surgery RD1-811
spellingShingle	Obstructive sleep apnea Hypoglossal nerve stimulator Drug-induced sleep endoscopy Treatment Predictor Otorhinolaryngology RF1-547 Surgery RD1-811 Tiffany N. Chao Erica R. Thaler Predictors of success in hypoglossal nerve stimulator implantation for obstructive sleep apnea
description	Objective: 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. Study design: Retrospective chart review. Setting: Single-institution academic tertiary care medical center. Subjects: 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. Results: 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 (P = 0.05). Patients observed to have partial lateral oropharyngeal collapse on DISE was more frequently associated with the treatment failure group than in the success group (P = 0.04). Conclusion: 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.
format	article
author	Tiffany N. Chao Erica R. Thaler
author_facet	Tiffany N. Chao Erica R. Thaler
author_sort	Tiffany N. Chao
title	Predictors of success in hypoglossal nerve stimulator implantation for obstructive sleep apnea
title_short	Predictors of success in hypoglossal nerve stimulator implantation for obstructive sleep apnea
title_full	Predictors of success in hypoglossal nerve stimulator implantation for obstructive sleep apnea
title_fullStr	Predictors of success in hypoglossal nerve stimulator implantation for obstructive sleep apnea
title_full_unstemmed	Predictors of success in hypoglossal nerve stimulator implantation for obstructive sleep apnea
title_sort	predictors of success in hypoglossal nerve stimulator implantation for obstructive sleep apnea
publisher	KeAi Communications Co., Ltd.
publishDate	2021
url	https://doaj.org/article/797ec2f06cec4361ae5ddcc67533e656
work_keys_str_mv	AT tiffanynchao predictorsofsuccessinhypoglossalnervestimulatorimplantationforobstructivesleepapnea AT ericarthaler predictorsofsuccessinhypoglossalnervestimulatorimplantationforobstructivesleepapnea
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Predictors of success in hypoglossal nerve stimulator implantation for obstructive sleep apnea

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