TY - JOUR
T1 - Previous Surgery and Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea
AU - Kezirian, Eric J.
AU - Heiser, Clemens
AU - Steffen, Armin
AU - Boon, Maurits
AU - Hofauer, Benedikt
AU - Doghramji, Karl
AU - Maurer, Joachim T.
AU - Sommer, J. Ulrich
AU - Soose, Ryan J.
AU - Schwab, Richard
AU - Thaler, Erica
AU - Withrow, Kirk
AU - Kominsky, Alan
AU - Larsen, Christopher G.
AU - Hsia, Jennifer
AU - Mehra, Reena
AU - Waters, Tina
AU - Strohl, Kingman
N1 - Publisher Copyright:
© American Academy of Otolaryngology–Head and Neck Surgery Foundation 2019.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Objective: To examine whether previous palate or hypopharyngeal surgery was associated with efficacy of treatment of obstructive sleep apnea with hypoglossal nerve stimulation. Study Design: Cohort (retrospective and prospective). Setting: Eleven academic medical centers. Subjects and Methods: Adults treated with hypoglossal nerve stimulation were enrolled in the ADHERE Registry. Outcomes were defined by the apnea-hypopnea index (AHI), in 3 ways: change in the AHI and 2 definitions of therapy response requiring ≥50% reduction in the AHI to a level <20 events/h (Response20) or 15 events/h (Response15). Previous palate and hypopharyngeal (tongue, epiglottis, or maxillofacial) procedures were documented. Linear and logistic regression examined the association between previous palate or hypopharyngeal surgery and outcomes, with adjustment for age, sex, and body mass index. Results: The majority (73%, 217 of 299) had no previous palate or hypopharyngeal surgery, while 25% and 9% had previous palate or hypopharyngeal surgery, respectively, including 6% with previous palate and hypopharyngeal surgery. Baseline AHI (36.0 ± 15.6 events/h) decreased to 12.0 ± 13.3 at therapy titration (P <.001) and 11.4 ± 12.6 at final follow-up (P <.001). Any previous surgery, previous palate surgery, and previous hypopharyngeal surgery were not clearly associated with treatment response; for example, any previous surgery was associated with a 0.69 (95% CI: 0.37, 1.27) odds of response (Response20 measure) at therapy titration and a 0.55 (95% CI: 0.22, 1.34) odds of response (Response20 measure) at final follow-up. Conclusion: Previous upper airway surgery was not clearly associated with efficacy of hypoglossal nerve stimulation.
AB - Objective: To examine whether previous palate or hypopharyngeal surgery was associated with efficacy of treatment of obstructive sleep apnea with hypoglossal nerve stimulation. Study Design: Cohort (retrospective and prospective). Setting: Eleven academic medical centers. Subjects and Methods: Adults treated with hypoglossal nerve stimulation were enrolled in the ADHERE Registry. Outcomes were defined by the apnea-hypopnea index (AHI), in 3 ways: change in the AHI and 2 definitions of therapy response requiring ≥50% reduction in the AHI to a level <20 events/h (Response20) or 15 events/h (Response15). Previous palate and hypopharyngeal (tongue, epiglottis, or maxillofacial) procedures were documented. Linear and logistic regression examined the association between previous palate or hypopharyngeal surgery and outcomes, with adjustment for age, sex, and body mass index. Results: The majority (73%, 217 of 299) had no previous palate or hypopharyngeal surgery, while 25% and 9% had previous palate or hypopharyngeal surgery, respectively, including 6% with previous palate and hypopharyngeal surgery. Baseline AHI (36.0 ± 15.6 events/h) decreased to 12.0 ± 13.3 at therapy titration (P <.001) and 11.4 ± 12.6 at final follow-up (P <.001). Any previous surgery, previous palate surgery, and previous hypopharyngeal surgery were not clearly associated with treatment response; for example, any previous surgery was associated with a 0.69 (95% CI: 0.37, 1.27) odds of response (Response20 measure) at therapy titration and a 0.55 (95% CI: 0.22, 1.34) odds of response (Response20 measure) at final follow-up. Conclusion: Previous upper airway surgery was not clearly associated with efficacy of hypoglossal nerve stimulation.
KW - hypoglossal nerve stimulation
KW - obstructive sleep apnea
KW - surgery
UR - http://www.scopus.com/inward/record.url?scp=85068340596&partnerID=8YFLogxK
U2 - 10.1177/0194599819856339
DO - 10.1177/0194599819856339
M3 - Article
C2 - 31234734
AN - SCOPUS:85068340596
SN - 0194-5998
VL - 161
SP - 897
EP - 903
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
IS - 5
ER -