A novel nasopharyngeal stent for the treatment of obstructive sleep apnea: a case series of nasopharyngeal stenting versus continuous positive airway pressure

Traxdorf, Maximilian; Hartl, Michael; Angerer, Florian; Bohr, Christopher; Grundtner, Philipp; Iro, Heinrich

doi:10.1007/s00405-015-3815-2

Cited by 9 publications

(10 citation statements)

References 21 publications

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“…Study using the device shows a moderate decrease in the AHIs with correction of obstructive apneas and correction of apnea induced oxygen desaturation. The device though was not as effective as CPAP 104 .…”

Section: Computerized Surgical Planningmentioning

confidence: 79%

Novel Therapies in the Treatment of Obstructive Sleep Apnea

Bhattacharya¹,

Chakrabarti²

2015

Indian Journal of Sleep Medicine

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There is an effort on several fronts for newer effective therapy for obstructive sleep apnea. This is because, till now the two main modalities of therapy, continuous positive airway pressure therapy or use of various oral appliances are fraught with problems of poor acceptance and long time adherence. Though numerous modalities have been tried which are discussed in the review, there are few novel approaches which hold great promise as probable effective modalities for the future. In children, the simplest cost effective treatment undoubtedly remains a well timed adeno-tonsillectomy which could as well be curative. However, a high flow open nasal cannula based positive airway pressure therapy has been found to be effective in mild and moderately obese children. In adults, oral pressure therapy using an external suction apparatus connected to an intra oral device, that increases the retropharyngeal space and prevents the tongue from falling back, has been found to be effective in initial studies. Stimulation of the genioglossus by hypoglossal nerve pacing with the use of a pulse generator placed in the infraclavicular region is another promising modality. Various new surgical techniques specially the maxilla mandibular advancement procedures and computerized surgical planning methods hold great promise. Lastly, the multimodality approach using the new knowledge on the pathophysiology of sleep apnea is likely to be the therapy for the future.

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Section: Computerized Surgical Planningmentioning

confidence: 79%

Novel Therapies in the Treatment of Obstructive Sleep Apnea

Bhattacharya¹,

Chakrabarti²

2015

Indian Journal of Sleep Medicine

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“…However, for potential effectiveness on UA obstruction, the distal tip should also theoretically reach an area within 1 cm of the epiglottis . Conversely, only few nasally administered devices actually target the oropharynx . A recent case series of eight patients treated with such a device reported a mean AHI reduction of 38.7% (AHI = 31.1 ± 12.0 vs. 19 ± 12.0) with the stent, in comparison to a mean reduction of 73.6% under CPAP (AHI = 8.2 ± 11.9) .…”

Section: Discussionmentioning

confidence: 99%

“…Conversely, only few nasally administered devices actually target the oropharynx . A recent case series of eight patients treated with such a device reported a mean AHI reduction of 38.7% (AHI = 31.1 ± 12.0 vs. 19 ± 12.0) with the stent, in comparison to a mean reduction of 73.6% under CPAP (AHI = 8.2 ± 11.9) . Sufficiently long nasal trumpets are usually not used in general practice or research due to limited tolerability…”

Section: Discussionmentioning

confidence: 99%

“…9,10 A recent case series of eight patients treated with such a device reported a mean AHI reduction of 38.7% (AHI = 31.1 ± 12.0 vs. 19 ± 12.0) with the stent, in comparison to a mean reduction of 73.6% under CPAP (AHI = 8.2 ± 11.9). 10 Sufficiently long nasal trumpets are usually not used in general practice 7 or research due to limited tolerability. 9 The studied device here may be suitable for patients who show adequate tolerance to oral appliance and gag reflex.…”

Section: Discussionmentioning

confidence: 99%

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First Successful Mechanical Splint for Obstructive Sleep Apnea With an Orally Administrable Pharyngeal Stenting Device

Neu

Newell

et al. 2018

The Laryngoscope

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We report the case of obstructive sleep apnea in a 19-year-old, otherwise healthy male presenting with persistent daytime sleepiness and nonrestorative sleep after velo- and uvuloplasty. An individually tailored prototype of an orally inserted pharyngeal stenting device was proposed in the framework of a first clinical feasibility trial. The noninvasive, easily self-administered device is mounted on a simple inferior dental guard. Baseline total apnea-hypopnea index (AHI) was 15.5 and 24.4 per hour of rapid eye movement (REM) sleep. With the device, total AHI dropped to 6.7 per hour (56.8% reduction) and 1.4 per hour of REM (94.3% reduction). Recorded sleep efficiency during treatment was excellent at 96.5%.

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“…An automated nasopharyngeal point-based registration that utilizes titanium spherical fiducials combined with EMT systems serves this purpose. A titanium nasal stent based on the AlaxoStent (Alaxo GmbH, Germany) normally used for breathing enhancement in patients [ 12 ]—served to elaborate minimally invasive positioning and stabilization of four spherical fiducials and isocentrically mounted magnetic position sensors in the nasopharynx prior to preoperative imaging (Fig. 2 ).…”

Section: Methodsmentioning

confidence: 99%

Novel microscope-based visual display and nasopharyngeal registration for auditory brainstem implantation: a feasibility study in an ex vivo model

et al. 2021

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Purpose An auditory brainstem implant (ABI) represents an alternative for patients with profound hearing loss who are constrained from receiving a cochlear implant. The positioning of the ABI electrode influences the patient’s auditory capacity and, therefore, quality of life and is challenging even with available intraoperative electrophysiological monitoring. This work aims to provide and assess the feasibility of visual-spatial assistance for ABI positioning. Methods The pose of the forceps instrument that grasps the electrode was electromagnetically navigated and interactively projected in the eyepieces of a surgical microscope with respect to a target point. Intraoperative navigation was established with an experimental technique for automated nasopharyngeal patient registration. Two ABI procedures were completed in a human specimen head. Results An intraoperative usability study demonstrated lower localization error when using the proposed visual display versus standard cross-sectional views. The postoperative evaluations of the preclinical study showed that the center of the electrode was misplaced to the planned position by 1.58 mm and 3.16 mm for the left and the right ear procedure, respectively. Conclusion The results indicate the potential to enhance intraoperative feedback during ABI positioning with the presented system. Further improvements consider estimating the pose of the electrode itself to allow for better orientation during placement.

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A novel nasopharyngeal stent for the treatment of obstructive sleep apnea: a case series of nasopharyngeal stenting versus continuous positive airway pressure

Cited by 9 publications

References 21 publications

Novel Therapies in the Treatment of Obstructive Sleep Apnea

Novel Therapies in the Treatment of Obstructive Sleep Apnea

First Successful Mechanical Splint for Obstructive Sleep Apnea With an Orally Administrable Pharyngeal Stenting Device

Novel microscope-based visual display and nasopharyngeal registration for auditory brainstem implantation: a feasibility study in an ex vivo model

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