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

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.