scholarly journals Three-Year Outcomes of Cranial Nerve Stimulation for Obstructive Sleep Apnea

2015 ◽  
Vol 154 (1) ◽  
pp. 181-188 ◽  
Author(s):  
B. Tucker Woodson ◽  
Ryan J. Soose ◽  
M. Boyd Gillespie ◽  
Kingman P. Strohl ◽  
Joachim T. Maurer ◽  
...  
2018 ◽  
Vol 128 (11) ◽  
pp. 2635-2643 ◽  
Author(s):  
Raj C. Dedhia ◽  
Arshed A. Quyyumi ◽  
Jeanie Park ◽  
Amit J. Shah ◽  
Patrick J. Strollo ◽  
...  

FACE ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 65-70
Author(s):  
Paul B. Lee ◽  
Michael T. Chung ◽  
Jared Johnson ◽  
Jordyn Lucas ◽  
Caitlin R. Priest ◽  
...  

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.


2020 ◽  
Author(s):  
Diane C Lim ◽  
Richard J Schwab

As part 2 of three chapters on sleep disordered breathing, this chapter reviews obstructive sleep apnea (OSA) diagnosis and management. OSA should be considered in all patients who have loud habitual snoring, excessive daytime sleepiness, and witnessed apneas. On physical examination, craniofacial abnormalities that can lead to sleep apnea include retrognathia, micrognathia, a narrow hard palate, nasal obstruction, an overjet, and an overbite. Enlargement of the upper airway soft tissue structures (the tongue, soft palate, lateral walls, and parapharyngeal fat pads) also increases the risk of OSA. The gold standard for making the diagnosis of OSA is overnight polysomnography, but home sleep apnea tests (HSAT) are rapidly gaining acceptance, especially in patients with a high probability of OSA. The first line of therapy for OSA remains positive airway pressure (PAP), with the second line of therapy being oral appliances. Another alternative to PAP therapy is hypoglossal nerve stimulation, which has been shown to decrease the Apnea-Hypopnea index by 67.4%. This review contains 6 figures, 3 tables, and 52 references. Key Words: craniofacial abnormalities, Epworth Sleepiness Scale, home sleep apnea test, hypoglossal nerve stimulation, obstructive sleep apnea, oral appliances, oral pharyngeal crowding, polysomnography, positive airway pressure, STOP-BANG


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

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M Mahmoud ◽  
A Mohamed ◽  
A Mohamed ◽  
H Nasr

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.


SLEEP ◽  
2019 ◽  
Vol 42 (Supplement_1) ◽  
pp. A220-A220
Author(s):  
Clara H Lee ◽  
James Reese ◽  
Everett G Seay ◽  
Xin Wu ◽  
Raj C Dedhia

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