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Managing Complete Concentric Collapse in Obstructive Sleep Apnea: A Narrative Review
Kalin R Sorenson1, Abigail Fish2, Benjamin D Brooks3
1Otolaryngology, Rocky Vista University College of Osteopathic Medicine, Ivins, USA.
Cureus
|October 13, 2025
Summary
Obstructive sleep apnea with complete concentric collapse is hard to treat. Bilateral hypoglossal nerve stimulation may offer a new solution for airway stability, reducing the need for invasive surgeries.
Area of Science:
- Sleep Medicine
- Otolaryngology
- Surgical Innovation
Background:
- Obstructive sleep apnea (OSA) is a common disorder with serious health risks.
- Complete concentric collapse (CCC) of the airway presents unique treatment challenges.
- Conventional therapies like CPAP and HGNS are often less effective in CCC cases.
Purpose of the Study:
- To review current surgical treatments for OSA, focusing on CCC.
- To evaluate the limitations of hypoglossal nerve stimulation (HGNS) in CCC patients.
- To explore the potential of bilateral HGNS (B-HGNS) as an alternative therapy.
Main Methods:
- Narrative review of existing literature on OSA surgical treatments.
- Critical analysis of studies concerning HGNS efficacy and contraindications in CCC.
- Exploration of B-HGNS mechanisms and potential benefits.
Main Results:
- Standard OSA surgeries (UPPP, ESP, MMA) have limitations in CCC.
- HGNS effectiveness is debated in CCC due to airway dynamics.
- B-HGNS shows promise for synchronizing genioglossus muscles and enhancing airway stability.
Conclusions:
- Treating OSA with CCC requires specialized approaches.
- B-HGNS presents a potential advancement for improving airway stability in CCC patients.
- Further research is needed to validate B-HGNS and develop less invasive OSA treatments.
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