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Laryngoscope. 2018 Jun;128(6):1486-1489. doi: 10.1002/lary.26956. Epub 2017 Oct 31.

Upper airway stimulation therapy and prior airway surgery for obstructive sleep apnea.

Author information

1
Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.

Abstract

OBJECTIVE:

To determine if patients with prior airway surgery for obstructive sleep apnea (OSA) had increased benefit following implantation with hypoglossal nerve stimulator.

STUDY DESIGN:

Retrospective chart review at a single institution tertiary academic care center.

METHODS:

Following implantation with hypoglossal nerve stimulator device, the outcomes of patients who underwent prior airway surgery for OSA were compared with those who did not. Primary outcome measures included apnea-hypopnea index (AHI) and nadir oxyhemoglobin saturation (NOS) as measured by polysomnography. Secondary outcome measures included Epworth Sleepiness Scale.

RESULTS:

Forty-seven patients underwent implantation with hypoglossal nerve stimulator. Of these, 30 patients had undergone prior airway surgery for OSA, whereas 16 did not. Mean preoperative AHI and NOS were 39.3 ± 2.8 and 78% ± 1.8% for all patients, 39.4 ± 3.7 and 79% ± 14% for patients with prior airway surgery, and 39.1 ± 4.0 and 77% ± 2.6% for patients without prior surgery. Mean postoperative AHI and NOS were 3.9 ± 1.2 and 91% ± 0.4% for all patients, 4.2 ± 1.7 and 91% ± 0.5% for patients with prior surgery, and 3.4 ± 1.5 and 93% ± 0.6% for patients without prior surgery (P = 0.756 and 0.053, respectively).

CONCLUSION:

Overall, patients had significant improvement following implantation with hypoglossal nerve stimulator. Prior airway surgery had no statistically significant effect on postoperative AHI or NOS.

LEVEL OF EVIDENCE:

4. Laryngoscope, 128:1486-1489, 2018.

KEYWORDS:

Apnea-Hypopnea Index; Epworth Sleepiness Scale; Hypoglossal nerve stimulation; OSA; nadir oxyhemoglobin saturation; obstructive sleep apnea; upper airway stimulation

PMID:
29086415
DOI:
10.1002/lary.26956
[Indexed for MEDLINE]

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