Eli Van de Perck1,2, Jolien Beyers1,2, Marijke Dieltjens1,2, Sara Op de Beeck1,2, Johan Verbraecken3,4, Paul Van de Heyning1,2, An Boudewyns1,2, Olivier M Vanderveken5,6,7,8. 1. Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium. 2. Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium. 3. Multidisciplinary Sleep Disorders Centre, Antwerp University Hospital, Edegem, Belgium. 4. Department of Pulmonology, Antwerp University Hospital, Edegem, Antwerp, Belgium. 5. Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium. olivier.vanderveken@uza.be. 6. Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium. olivier.vanderveken@uza.be. 7. Multidisciplinary Sleep Disorders Centre, Antwerp University Hospital, Edegem, Belgium. olivier.vanderveken@uza.be. 8. Department of ENT, Head and Neck Surgery, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium. olivier.vanderveken@uza.be.
Abstract
PURPOSE: The aim of this study was to report on the successful application of upper airway stimulation (UAS) therapy in an adult Down syndrome (DS) patient with severe obstructive sleep apnea (OSA) and continuous positive airway pressure (CPAP) intolerance. METHODS: Baseline polysomnography (PSG) in a 23-year-old male OSA patient (body mass index (BMI) 24.4 kg/m2) revealed an apnea/hypopnea index (AHI) of 61.5 events/h and oxygen desaturation index (ODI) of 39.7 events/h. Based on the clinical examination, PSG and drug-induced sleep endoscopy, the patient fulfilled the formal inclusion criteria for UAS therapy: AHI between 15 and 65 events/h, BMI < 32 kg/m2, and no complete concentric collapse at the level of the velopharynx. RESULTS: Implantation of the hypoglossal nerve stimulator in the adult patient with DS resulted in a substantial subjective as well as objective improvement of OSA (63 to 81% decrease in AHI and 77% decrease in ODI), translating into an overall satisfactory outcome. CONCLUSION: Research on the long-term effectiveness of UAS therapy in a larger group of patients with DS is needed. However, based on the available literature and our presented case, respiration-synchronized electrostimulation of the hypoglossal nerve using UAS therapy may have a potential value in well-selected OSA patients with DS who are non-compliant to CPAP therapy.
PURPOSE: The aim of this study was to report on the successful application of upper airway stimulation (UAS) therapy in an adult Down syndrome (DS) patient with severe obstructive sleep apnea (OSA) and continuous positive airway pressure (CPAP) intolerance. METHODS: Baseline polysomnography (PSG) in a 23-year-old male OSA patient (body mass index (BMI) 24.4 kg/m2) revealed an apnea/hypopnea index (AHI) of 61.5 events/h and oxygen desaturation index (ODI) of 39.7 events/h. Based on the clinical examination, PSG and drug-induced sleep endoscopy, the patient fulfilled the formal inclusion criteria for UAS therapy: AHI between 15 and 65 events/h, BMI < 32 kg/m2, and no complete concentric collapse at the level of the velopharynx. RESULTS: Implantation of the hypoglossal nerve stimulator in the adult patient with DS resulted in a substantial subjective as well as objective improvement of OSA (63 to 81% decrease in AHI and 77% decrease in ODI), translating into an overall satisfactory outcome. CONCLUSION: Research on the long-term effectiveness of UAS therapy in a larger group of patients with DS is needed. However, based on the available literature and our presented case, respiration-synchronized electrostimulation of the hypoglossal nerve using UAS therapy may have a potential value in well-selected OSA patients with DS who are non-compliant to CPAP therapy.
Entities:
Keywords:
Down syndrome; Hypoglossal nerve stimulation; Sleep-disordered breathing; Surgery; Treatment
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