Hypoglossal nerve stimulation long-term clinical outcomes: a systematic review and meta-analysis

Costantino, Andrea; Rinaldi, Vittorio; Moffa, Antonio; Luccarelli, Vitaliana; Bressi, Federica; Cassano, Michele; Casale, Manuele; Baptista, Peter

doi:10.1007/s11325-019-01923-2

Cited by 89 publications

(77 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although HNS success rate is promising and comparable to other accepted surgical approaches (such as UPPP or modified-UPPP), almost one third of patients are considered as a nonresponder in the long-term period. 20 The reason why these patients do not benefit from HNS is currently unknown. On the other hand, some patients outside baseline inclusion parameters showed an optimal clinical response.…”

Section: Hypoglossal Nerve Stimulation In the Era Of Precision Medicinementioning

confidence: 99%

“…19 In the last years, several prospective studies on HNS have been published, and a recent meta-analysis showed that this non-anatomical modifying surgery is able to achieve an adequate long-term objective and subjective clinical outcome with reasonable complication rate. 20 Moreover, this new OSA treatment is getting more and more refined thanks to the device implementation, and a better establishment of patient selection and follow-up. The main drivers directly affecting the long-term clinical outcome are therefore the careful patient selection, the accurate placement of the stimulation electrodes during surgery, and the advanced titration therapy for muscle recruitment optimization.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

<p>Hypoglossal Nerve Stimulation in the Treatment of Obstructive Sleep Apnea: Patient Selection and New Perspectives</p>

Baptista¹,

Costantino²,

Moffa³

et al. 2020

NSS

Self Cite

View full text Add to dashboard Cite

Hypoglossal nerve stimulation (HNS) is an increasingly widespread OSA treatment. It is a non-anatomical modifying surgery able to achieve an adequate objective and subjective result with a reasonable complication rate. HNS exploits the neurostimulation to reduce upper airway collapsibility providing a multilevel upper airway improvement within a single procedure. Proper patient selection has a fundamental role in determining an adequate long-term clinical outcome. All patient candidates for HNS undergo a standard comprehensive sleep medicine assessment and upper airway surgical examination. Several features should be assessed preoperatively in order to predict patients' response to HNS treatment. In particular, the assessment of OSA severity, BMI > 32 Kg/m 2 , collapse pattern during drug-induced sleep endoscopy (DISE), and many other parameters, is central for a good patient selection and customization of OSA treatment. HNS is indeed one of the most promising tools in the widespread context of personalized sleep medicine. HNS is an adjustable medical device that could be titrated in order to improve HNS effectiveness, maintaining patient comfort. Moreover, HNS provides the opportunity for patients to play an active role in their own care, with a potential improvement in therapy adherence and efficacy. This review summarizes the current evidence in patient selection for HNS, highlighting the reasons behind the optimistic future of this OSA treatment in the context of personalized medicine.

show abstract

Section: Hypoglossal Nerve Stimulation In the Era Of Precision Medicinementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

<p>Hypoglossal Nerve Stimulation in the Treatment of Obstructive Sleep Apnea: Patient Selection and New Perspectives</p>

Baptista¹,

Costantino²,

Moffa³

et al. 2020

NSS

Self Cite

View full text Add to dashboard Cite

show abstract

“…Sie bewirkt eine Kontraktion des M. genioglossus mit konsekutiver oberer Atemwegsöffnung [87]. Aktuell gibt es unterschiedliche Verfahren zur Stimulation des N. hy-poglossus, die aufgrund ihrer klinischen Ergebnisse auch unterschiedlich betrachtet werden müssen [88,89] [105,110].…”

Section: Chirurgische Therapieverfahrenunclassified

Teil-Aktualisierung S3-Leitlinie Schlafbezogene Atmungsstörungen bei Erwachsenen

et al. 2020

View full text Add to dashboard Cite

“…Kompelli et al [ 53 ] analyzed 381 patients across 16 studies and reported a mean AHI reduction of 21.1 events per hour (95% confidence interval [CI], 16.9–25.3 events per hour), a mean oxygen desaturation index decrease by 15.0 (95% CI, 12.7–17.4), a mean Epworth Sleepiness Scale decrease by 5.0 (95% CI, 4.2–5.8), and a mean Functional Outcomes of Sleep Questionnaire increase by 3.1 (95% CI, 2.6–3.4). Costantino et al [ 54 ] compared surgical results across UAS devices, and reported mean AHI reductions of 17.5 events per hour (inspire; 95% CI, 14.98–20.01 events per hour), 24.20 (ImThera; 95% CI, 11.01–37.39 events per hour), and 20.10 (Apnex; 95% CI, 10.58–29.62 events per hour) at 12 months after surgery. The surgical success rate was 72.4% (Inspire), 76.9% (ImThera), and 55% (Apnex) at 12 months, and 75% (Inspire) at a 60-month follow-up.…”

Section: Upper Airway Stimulationmentioning

confidence: 99%

Maxillomandibular Advancement and Upper Airway Stimulation: Extrapharyngeal Surgery for Obstructive Sleep Apnea

Ibrahim

Riley

et al. 2020

Clin Exp Otorhinolaryngol

View full text Add to dashboard Cite

There are many ways to categorize surgery for obstructive sleep apnea (OSA), one of which is to distinguish between intrapharyngeal and extrapharyngeal procedures. While the general otolaryngologist treating OSA is familiar with intrapharyngeal procedures, such as uvulopalatopharyngoplasty and tongue base reduction, extrapharyngeal sleep operations such as maxillomandibular advancement (MMA) and upper airway stimulation (UAS) have evolved rapidly in the recent decade and deserve a dedicated review. MMA and UAS have both shown predictable high success rates with low morbidity. Each approach has unique strengths and limitations, and for the most complex of OSA patients, the two in combination complement each other. Extrapharyngeal airway operations are critical for achieving favorable outcomes for sleep surgeons.

show abstract

Hypoglossal nerve stimulation long-term clinical outcomes: a systematic review and meta-analysis

Cited by 89 publications

References 34 publications

<p>Hypoglossal Nerve Stimulation in the Treatment of Obstructive Sleep Apnea: Patient Selection and New Perspectives</p>

<p>Hypoglossal Nerve Stimulation in the Treatment of Obstructive Sleep Apnea: Patient Selection and New Perspectives</p>

Teil-Aktualisierung S3-Leitlinie Schlafbezogene Atmungsstörungen bei Erwachsenen

Maxillomandibular Advancement and Upper Airway Stimulation: Extrapharyngeal Surgery for Obstructive Sleep Apnea

Contact Info

Product

Resources

About