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Previous Surgery and Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea
Eric J Kezirian1, Clemens Heiser2, Armin Steffen3
1Keck School of Medicine of the University of Southern California, Los Angeles, California, USA.
Summary
Previous upper airway surgery did not significantly impact the effectiveness of hypoglossal nerve stimulation for treating obstructive sleep apnea. This study found no clear association between prior palate or hypopharyngeal procedures and treatment outcomes.
Area of Science:
- Sleep Medicine
- Otolaryngology
- Surgical Innovation
Background:
- Obstructive sleep apnea (OSA) affects millions, with hypoglossal nerve stimulation (HNS) emerging as a key treatment.
- Previous upper airway surgeries are common in OSA patients, raising questions about their influence on HNS efficacy.
Purpose of the Study:
- To investigate the association between prior palate or hypopharyngeal surgery and the effectiveness of HNS in treating OSA.
- To determine if patients with a history of specific upper airway surgeries respond differently to HNS therapy.
Main Methods:
- A retrospective and prospective cohort study involving 299 adults in the ADHERE Registry treated with HNS.
- Outcomes were assessed using the apnea-hypopnea index (AHI) and defined response criteria (Response20/Response15).
- Statistical analysis (linear and logistic regression) adjusted for age, sex, and BMI to evaluate the impact of previous surgeries.
Main Results:
- The majority of patients (73%) had no prior palate or hypopharyngeal surgery.
- HNS significantly reduced AHI from baseline (36.0) to final follow-up (11.4) (P < .001).
- No clear association was found between any previous surgery, palate surgery, or hypopharyngeal surgery and treatment response.
Conclusions:
- Previous upper airway surgery does not appear to significantly affect the efficacy of hypoglossal nerve stimulation for OSA treatment.
- HNS remains a viable and effective treatment option for OSA patients, irrespective of their surgical history in the palate or hypopharynx.
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