Post-operative Complication Rate Comparison Between Airway Surgery and Upper Airway Stimulation Using NSQIP and...

Area of Science:

• Sleep Medicine
• Surgical Outcomes
• Otolaryngology

Background:

• Obstructive sleep apnea (OSA) significantly impacts patient health and quality of life.
• Surgical interventions for OSA aim to improve airway patency and reduce respiratory events.
• Comparing the safety and efficacy of different OSA surgical approaches is crucial for clinical decision-making.

Purpose of the Study:

• To compare postoperative complication rates between hypoglossal nerve upper airway stimulation (UAS) and traditional obstructive sleep apnea surgery (OSAS).
• To evaluate the safety profile of UAS versus OSAS in a real-world clinical setting.

Main Methods:

• A retrospective cohort study utilizing multi-institutional international databases.
• Data for OSAS were sourced from the NSQIP database, and for UAS from the ADHERE registry.
• Comorbidities and complications were standardized across databases, with chi-square tests used for statistical analysis.

Main Results:

• The UAS cohort (n=1623) was older and had higher rates of hypertension, diabetes, and heart disease than the OSAS cohort (n=310).
• Despite baseline differences, UAS demonstrated significantly lower 30-day return to operating room rates (0.1% vs 4.8%) and surgical site infections (0.13% vs 0.9%) compared to OSAS.
• Postoperative length of stay was shorter for UAS (71% <1 day) than for OSAS (40% <1 day).

Conclusions:

• Hypoglossal nerve upper airway stimulation (UAS) is associated with a lower postoperative complication rate than obstructive sleep apnea surgery (OSAS).
• UAS appears to be a safer alternative, even in older patients with significant comorbidities.
• These findings support UAS as a viable and potentially preferable treatment option for select OSA patients.