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Ann Otol Rhinol Laryngol. 2018 Jun;127(6):379-383. doi: 10.1177/0003489418771395. Epub 2018 Apr 30.

Comparing Upper Airway Stimulation to Expansion Sphincter Pharyngoplasty: A Single University Experience.

Author information

1
1 Department of Otolaryngology, Head & Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
2
2 Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
3
3 Jefferson Sleep Disorders Center, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

Abstract

INTRODUCTION:

Expansion sphincter pharyngoplasty (ESP) is a surgical option for patients with obstructive sleep apnea (OSA). Upper airway stimulation (UAS) is an alternative that has shown success in initial outcomes studies. We compare outcomes of a cohort of patients undergoing UAS to ESP.

METHODS:

We compared demographic and polysomnographic data of the UAS to ESP cohorts. We also calculated the proportion of patients achieving surgical success.

RESULTS:

The ESP cohort consisted of 33 patients. The mean preoperative Apnea-Hypopnea Index (AHI), O2 nadir, Epworth Sleepiness Scale (ESS), and BMI were 36.47 ± 20.01, 82.63 ± 5.37, 10.69 ± 4.42, and 29.6 ± 4.49, which improved to 13.47 ± 18.74, 84.84 ± 5.48, 7.00 ± 5.81, and 29.92 ± 4.59 postoperatively. There was a 63.64% success rate. The UAS cohort consisted of 75 patients. The mean preoperative AHI, O2 nadir, ESS, and BMI were 36.76 ± 20.72, 80.24 ± 8.43, 11.18 ± 4.16, and 29.50 ± 3.96, which improved to 7.25 ± 11.19, 88.71 ± 3.25, 5.36 ± 3.35, and 29.36 ± 3.68 postoperatively. The success rate was 86.67%. We found a significant difference in gender, age, preoperative AHI, postoperative AHI, postoperative O2 nadir, surgical success, and patients reaching an AHI less than 10 and 5.

CONCLUSION:

Upper airway stimulation is a new surgical option for select patients with OSA showing comparable or improved outcomes to a cohort of patients undergoing ESP.

KEYWORDS:

adult OSA surgical treatment; obstructive sleep apnea; sleep apnea; sleep disordered breathing; sleep medicine

PMID:
29707958
DOI:
10.1177/0003489418771395
[Indexed for MEDLINE]

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