Update on hypoglossal nerve stimulation in children with down syndrome and obstructive sleep apnea

2020 ◽  
Vol 130 (4) ◽  
Author(s):  
Christen L. Caloway ◽  
Gillian R. Diercks ◽  
Donald Keamy ◽  
Vanessa Guzman ◽  
Ryan Soose ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Down Syndrome ◽  
Sleep Apnea ◽  
Nerve Stimulation ◽  
Hypoglossal Nerve ◽  
Hypoglossal Nerve Stimulation ◽  
Children With Down Syndrome ◽  
Obstructive Sleep

Tongue-Based Procedures in Treating Refractory Obstructive Sleep Apnea in Down Syndrome Patients: A Systematic Review and Meta-Analysis

FACE ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 65-70
Author(s):  
Paul B. Lee ◽  
Michael T. Chung ◽  
Jared Johnson ◽  
Jordyn Lucas ◽  
Caitlin R. Priest ◽  
...  
Keyword(s):  
Systematic Review ◽  
Obstructive Sleep Apnea ◽  
Down Syndrome ◽  
Sleep Apnea ◽  
Nerve Stimulation ◽  
Hypoglossal Nerve ◽  
Meta Analysis ◽  
Apnea Hypopnea Index ◽  
Hypoglossal Nerve Stimulation ◽  
Obstructive Sleep

Objective: There is a high prevalence of obstructive sleep apnea (OSA) in pediatric and adult Down Syndrome (DS) patients that is refractory to adenotonsillectomy and continuous positive airway pressure. Newer treatment modalities have emerged with improved outcomes. The objective is to provide an updated systematic review and meta-analysis to analyze the clinical outcomes of OSA in pediatric and adult DS patients with hypoglossal nerve stimulation using Inspire, midline posterior glossectomy plus lingual tonsillectomy (MPG + LT), and combined genioglossus advancement plus radiofrequency (GGS + RF). Methods: A comprehensive literature search of PubMed and Google Scholar was performed followed by a meta-analysis. Studies with preoperative and post-operative Apnea Hypopnea Index (AHI) values were included with patients serving as their own control. Results: Across 5 studies, 56 patients were analyzed. The mean reduction in AHI was statistically significant before vs. after procedure ( P < .001 for hypoglossal nerve stimulation using Inspire with a paired 2-tailed t-test and P = .031 for MPG + LT). Although individual patient AHI values were unavailable in the GGS + RF study, the standard difference in mean AHI was also significant for GGS + RF with P = .001. Device malfunction was the most common complication for Inspire while postoperative bleeding was observed for MPG + LT and nasopharyngeal obstruction and retropalatal collapse were observed for GGS + RF. Conclusion: This review reveals significant improvement in AHI with Inspire, MPG + LT, and GGS + RF for DS patients with refractory OSA. Further investigation is needed for comparison between these 3 therapies.

Hypoglossal Nerve Stimulation in Veterans with Obstructive Sleep Apnea

2019 ◽  
Vol 130 (9) ◽  
pp. 2275-2280 ◽  
Author(s):  
Kathleen M. Sarber ◽  
Katherine W. Chang ◽  
Madison V. Epperson ◽  
Meredith E. Tabangin ◽  
Mekibib Altaye ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Nerve Stimulation ◽  
Hypoglossal Nerve ◽  
Hypoglossal Nerve Stimulation ◽  
Obstructive Sleep

scholarly journals Effectiveness of Hypoglossal Nerve Stimulation in the Treatment of Obstructive Sleep Apnea (Meta-analytic Study)

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M Mahmoud ◽  
A Mohamed ◽  
A Mohamed ◽  
H Nasr
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Outcome Measures ◽  
Nerve Stimulation ◽  
Primary Outcome ◽  
Hypoglossal Nerve ◽  
Mean Difference ◽  
Hypoglossal Nerve Stimulation ◽  
Obstructive Sleep ◽  
Standardized Mean Difference

Abstract Background Obstructive sleep apnea (OSA) is a serious, potentially life-threatening disorder. There are many treatment modalities are being used, but none of them gained consensus. Continuous positive airway pressure considered the most widely accepted treatment of OSA but very poor adherence limits its effectiveness, thus was the need for alternative therapy of high compliance and effective for long term. Aim of the Work To perform a meta-analysis of the available studies included outcomes of hypoglossal nerve stimulation to evaluate its effectiveness as a choice of treatment of obstructive sleep apnea. Patients and Methods The study included published medical articles that evaluated the efficacy of hypoglossal nerve stimulation as treatment of obstructive sleep apnea with outcomes for primary outcome measures apnea-hypopnea index (AHI), oxygen desaturation index (ODI), and for secondary outcome measures Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ) before and after implantation. Results Eight prospective studies with 329 patients were included in this met analysis. At 12 months, statistical analysis demonstrated significant reductions in AHI, ODI with standardized mean difference of -1.3940 (95% CI: -1.7745 to -1.0136; P = 0.0042), -0.9188 (95% CI: -1.3040 to -0.5337; p = 0.0002) respectively, and -not significant- reduction in ESS, FOSQ with standardized mean difference of -1.0365 (95% CI: -1.1889 to -0.8841; p = 0.2290), 1.0545 (95% CI: 0.8867 to 1.2223; p = 0.4922), respectively. Similar were observed at 6 months. Conclusion Hypoglossal nerve stimulation results in significant improvement of primary outcome measures of OSA with significant reduction of apnea episodes. It could be considered as an effective -but still of high cost- alternative for OSA patients. Further studies comparing HNS to other therapies are needed.

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