Upper airway stimulation vs other upper airway surgical procedures for OSA: a meta-analysis

2021 ◽  
Author(s):  
Chairat Neruntarat ◽  
Pisit Wanichakorntrakul ◽  
Kitsarawut Khuancharee ◽  
Petcharat Saengthong ◽  
Mongkol Tangngekkee
Keyword(s):  
Surgical Procedures ◽  
Meta Analysis ◽  
Upper Airway ◽  
Upper Airway Stimulation

Adherence of Upper Airway Stimulation in US and German Medical Centers: A Multicenter Meta-Analysis on Adhere Registry

2020 ◽  
Author(s):  
Jingxin Lei ◽  
Kent Lee
Keyword(s):  
Meta Analysis ◽  
Upper Airway ◽  
Study Cohort ◽  
Significant Heterogeneity ◽  
Upper Airway Stimulation ◽  
Medical Centers ◽  
Obstructive Sleep ◽  
High Adherence ◽  
International Multicenter ◽  
Multicenter Registry

Abstract Upper airway stimulation (UAS) is shown to be effective with high adherence for patients with moderate to severe obstructive sleep apnea. However, the consistency of adherence among medical sites remains to be verified. This study examines the adherence to UAS among medical sites in an international multicenter registry. A statistically significant adherence decrease between 6-month and 12-month visit was found in the study cohort as well as in most sites. No significant heterogeneity was found among sites with either all patients or only patients who had adherence at both visits recorded. In addition, there is no enough evidence that region and experience of sites influences the adherence. This study indicates that UAS therapy adherence is consistent among sites, regardless of region and experience of sites.

Upper airway stimulation: Fewer complications, ED presentations, readmissions, and increased surgical success

2021 ◽  
Vol 42 (5) ◽  
pp. 103035
Author(s):  
Matthew Stewart ◽  
Leonard Estephan ◽  
Hamad Sagheer ◽  
Joseph M. Curry ◽  
Maurits Boon ◽  
...  
Keyword(s):  
Upper Airway ◽  
Upper Airway Stimulation ◽  
Surgical Success

scholarly journals Chronic subdural hematoma: a systematic review and meta-analysis of surgical procedures

2014 ◽  
Vol 121 (3) ◽  
pp. 665-673 ◽  
Author(s):  
Weiming Liu ◽  
Nicolaas A. Bakker ◽  
Rob J. M. Groen
Keyword(s):  
Outcome Measures ◽  
Surgical Procedures ◽  
Subdural Hematoma ◽  
Meta Analysis ◽  
Chronic Subdural Hematoma ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Twist Drill ◽  
Recurrence Rates ◽  
Postoperative Drainage

Object In this paper the authors systematically evaluate the results of different surgical procedures for chronic subdural hematoma (CSDH). Methods The MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and other databases were scrutinized according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) statement, after which only randomized controlled trials (RCTs) and quasi-RCTs were included. At least 2 different neurosurgical procedures in the management of chronic subdural hematoma (CSDH) had to be evaluated. Included studies were assessed for the risk of bias. Recurrence rates, complications, and outcome including mortality were taken as outcome measures. Statistical heterogeneity in each meta-analysis was assessed using the T2 (tau-squared), I2, and chi-square tests. The DerSimonian-Laird method was used to calculate the summary estimates using the fixed-effect model in meta-analysis. Results Of the 297 studies identified, 19 RCTs were included. Of them, 7 studies evaluated the use of postoperative drainage, of which the meta-analysis showed a pooled OR of 0.36 (95% CI 0.21–0.60; p < 0.001) in favor of drainage. Four studies compared twist drill and bur hole procedures. No significant differences between the 2 methods were present, but heterogeneity was considered to be significant. Three studies directly compared the use of irrigation before drainage. A fixed-effects meta-analysis showed a pooled OR of 0.49 (95% CI 0.21–1.14; p = 0.10) in favor of irrigation. Two studies evaluated postoperative posture. The available data did not reveal a significant advantage in favor of the postoperative supine posture. Regarding positioning of the catheter used for drainage, it was shown that a frontal catheter led to a better outcome. One study compared duration of drainage, showing that 48 hours of drainage was as effective as 96 hours of drainage. Conclusions Postoperative drainage has the advantage of reducing recurrence without increasing complications. The use of a bur hole or twist drill does not seem to make any significant difference in recurrence rates or other outcome measures. It seems that irrigation may lead to a better outcome. These results may lead to more standardized procedures.

Upper Airway Stimulation Therapy for Obstructive Sleep Apnea

2021 ◽  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Novel Therapy ◽  
Upper Airway Stimulation ◽  
Current State ◽  
Obstructive Sleep ◽  
Long Term Follow Up ◽  
Physician Extenders ◽  
Primary Care Practitioners

Upper Airway Stimulation Therapy for Obstructive Sleep Apnea provides the current state of knowledge regarding this novel therapy. It reviews the pathophysiologic basis of sleep apnea and the specific mechanism by which upper airway stimulation provides airway support in this disorder. It also provides practical insights into this therapy related to patient selection, clinical outcomes, surgical technique, long-term follow-up, and adverse events and offers recommendations for those aspiring to develop an upper airway stimulation program. It provides an overview of unique populations and circumstances that may extend the utility of the procedure, and that may provide challenges in management, as well as thoughts on the future of this technology. This textbook is intended for all practitioners who have interest or care for sleep disordered breathing, including sleep medicine physicians, pulmonologists, otolaryngologists, primary care practitioners, as well as physician extenders.

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