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A Protocolized Approach to Awake Endoscopy With Advanced Programming to Optimize Hypoglossal Nerve Stimulation.

Troy Wesson1, Mohamad Z Saltagi1, Shalini Manchanda1,2

  • 1Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
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Summary

Hypoglossal nerve stimulation offers an alternative for obstructive sleep apnea patients. Awake endoscopy with advanced programming (AEAP) helps optimize treatment outcomes and patient comfort post-implantation.

Keywords:
Inspireadvanced programmingawake endoscopyhypoglossal nerve stimulationneurostimulationobstructive sleep apneaupper airway stimulation

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Area of Science:

  • Neurology
  • Otolaryngology
  • Sleep Medicine

Background:

  • Obstructive sleep apnea (OSA) affects millions globally.
  • Positive airway pressure (PAP) therapy is a common OSA treatment.
  • Some patients are intolerant to PAP therapy, necessitating alternative solutions.

Purpose of the Study:

  • To describe the protocol for awake endoscopy with advanced programming (AEAP) for hypoglossal nerve stimulation (HNS) post-implantation.
  • To evaluate the outcomes and safety of implementing a protocolized AEAP approach in OSA patients.

Main Methods:

  • A review of the first 5 consecutive patients undergoing HNS implantation.
  • AEAP was utilized to guide programming adjustments for optimal AHI reduction and patient comfort.
  • Data collected included apnea-hypopnea index (AHI) changes and patient-reported outcomes.

Main Results:

  • AEAP guided programming adjustments in all reviewed patients.
  • Initial outcomes suggest feasibility and potential for optimizing HNS therapy.
  • Safety profile of the AEAP procedure was generally favorable.

Conclusions:

  • Awake endoscopy with advanced programming (AEAP) is a valuable tool for optimizing hypoglossal nerve stimulation therapy in OSA patients.
  • Protocolized AEAP implementation can enhance treatment efficacy and patient experience.
  • Further research with larger cohorts is warranted to confirm long-term benefits and safety.