Eric J Kezirian1, Clemens Heiser2, Armin Steffen3, Maurits Boon4, Benedikt Hofauer2, Karl Doghramji4, Joachim T Maurer5, J Ulrich Sommer6, Ryan J Soose7, Richard Schwab8, Erica Thaler8, Kirk Withrow9, Alan Kominsky10, Christopher G Larsen11, Jennifer Hsia12, Reena Mehra10, Tina Waters10, Kingman Strohl13. 1. Keck School of Medicine of the University of Southern California, Los Angeles, California, USA. 2. Klinikum rechts der Isar, Technical University of Munich, Munich, Germany. 3. University of Lubeck, Lubeck, Germany. 4. Thomas Jefferson University, Philadelphia, Pennsylvania, USA. 5. University-Hospital Mannheim, Mannheim, Germany. 6. Helios University Hospital, Wuppertal, Germany. 7. University of Pittsburgh, Pittsburgh, Pennsylvania, USA. 8. University of Pennsylvania, Philadelphia, Pennsylvania, USA. 9. University of Alabama, Birmingham, Alabama, USA. 10. Cleveland Clinic, Cleveland, Ohio, USA. 11. University of Kansas Medical Center, Kansas City, Kansas, USA. 12. University of Minnesota Fairview Hospital, Minneapolis, Minnesota, USA. 13. University Hospital, Cleveland, Ohio, USA.
Abstract
OBJECTIVE: To examine whether previous palate or hypopharyngeal surgery was associated with efficacy of treatment of obstructive sleep apnea with hypoglossal nerve stimulation. STUDY DESIGN: Cohort (retrospective and prospective). SETTING: Eleven academic medical centers. SUBJECTS AND METHODS: Adults treated with hypoglossal nerve stimulation were enrolled in the ADHERE Registry. Outcomes were defined by the apnea-hypopnea index (AHI), in 3 ways: change in the AHI and 2 definitions of therapy response requiring ≥50% reduction in the AHI to a level <20 events/h (Response20) or 15 events/h (Response15). Previous palate and hypopharyngeal (tongue, epiglottis, or maxillofacial) procedures were documented. Linear and logistic regression examined the association between previous palate or hypopharyngeal surgery and outcomes, with adjustment for age, sex, and body mass index. RESULTS: The majority (73%, 217 of 299) had no previous palate or hypopharyngeal surgery, while 25% and 9% had previous palate or hypopharyngeal surgery, respectively, including 6% with previous palate and hypopharyngeal surgery. Baseline AHI (36.0 ± 15.6 events/h) decreased to 12.0 ± 13.3 at therapy titration (P < .001) and 11.4 ± 12.6 at final follow-up (P < .001). Any previous surgery, previous palate surgery, and previous hypopharyngeal surgery were not clearly associated with treatment response; for example, any previous surgery was associated with a 0.69 (95% CI: 0.37, 1.27) odds of response (Response20 measure) at therapy titration and a 0.55 (95% CI: 0.22, 1.34) odds of response (Response20 measure) at final follow-up. CONCLUSION: Previous upper airway surgery was not clearly associated with efficacy of hypoglossal nerve stimulation.
OBJECTIVE: To examine whether previous palate or hypopharyngeal surgery was associated with efficacy of treatment of obstructive sleep apnea with hypoglossal nerve stimulation. STUDY DESIGN: Cohort (retrospective and prospective). SETTING: Eleven academic medical centers. SUBJECTS AND METHODS: Adults treated with hypoglossal nerve stimulation were enrolled in the ADHERE Registry. Outcomes were defined by the apnea-hypopnea index (AHI), in 3 ways: change in the AHI and 2 definitions of therapy response requiring ≥50% reduction in the AHI to a level <20 events/h (Response20) or 15 events/h (Response15). Previous palate and hypopharyngeal (tongue, epiglottis, or maxillofacial) procedures were documented. Linear and logistic regression examined the association between previous palate or hypopharyngeal surgery and outcomes, with adjustment for age, sex, and body mass index. RESULTS: The majority (73%, 217 of 299) had no previous palate or hypopharyngeal surgery, while 25% and 9% had previous palate or hypopharyngeal surgery, respectively, including 6% with previous palate and hypopharyngeal surgery. Baseline AHI (36.0 ± 15.6 events/h) decreased to 12.0 ± 13.3 at therapy titration (P < .001) and 11.4 ± 12.6 at final follow-up (P < .001). Any previous surgery, previous palate surgery, and previous hypopharyngeal surgery were not clearly associated with treatment response; for example, any previous surgery was associated with a 0.69 (95% CI: 0.37, 1.27) odds of response (Response20 measure) at therapy titration and a 0.55 (95% CI: 0.22, 1.34) odds of response (Response20 measure) at final follow-up. CONCLUSION: Previous upper airway surgery was not clearly associated with efficacy of hypoglossal nerve stimulation.
Entities:
Keywords:
hypoglossal nerve stimulation; obstructive sleep apnea; surgery
Authors: Maria V Suurna; Ofer Jacobowitz; Jolie Chang; Ioannis Koutsourelakis; David Smith; Uri Alkan; Mark D'Agostino; Maurits Boon; Clemens Heiser; Paul Hoff; Colin Huntley; David Kent; Alan Kominsky; Richard Lewis; Joachim T Maurer; Madeline J Ravesloot; Ryan Soose; Armin Steffen; Edward M Weaver; Amy M Williams; Tucker Woodson; Kathleen Yaremchuk; Stacey L Ishman Journal: J Clin Sleep Med Date: 2021-12-01 Impact factor: 4.062