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

作     者：Chao Tiffany N. Thaler Erica R. Chao Tiffany N.;Thaler Erica R.

作者机构：Department of Otorhinolaryngology-Head and Neck SurgeryUniversity of PennsylvaniaPhiladelphiaPAUSA 

出 版 物：《World Journal of Otorhinolaryngology-Head and Neck Surgery》 (世界耳鼻咽喉头颈外科杂志（英文）)

年 卷 期：2021年第7卷第1期

页      面：40-44页

学科分类：1002[医学-临床医学] 100213[医学-耳鼻咽喉科学] 10[医学] 

基　　金：Inspire Medical Systems 

主　　题：Obstructive sleep apnea Hypoglossal nerve stimulator Drug-induced sleep endoscopy Treatment Predictor 

摘      要：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 *** objective was to determine whether additional factors seen on preoperative evaluation could be used as predictors of surgical *** design:Retrospective chart ***:Single-institution academic tertiary care medical ***:and Methods:This study included patients with obstructive sleep apnea(OSA)who underwent HGNS implantation between 2015 and *** success was defined as a post-operative 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 ***:A total of 68 patients were included in 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 *** that may predispose patients to surgical failure included the presence of lateral oropharyngeal collapse and a significantly elevated preoperative *** should be considered when determining surgical candidacy for HGNS implantation.