Success Rate of N. hypoglossus Stimulation – Do previous surgery on the Airway have an effect?

Introduction:

The goal of the study was the retrospective analysis of subjective and objective results of stimulation therapy of the hypoglossal nerve in patients who have already had previous OSA surgery.

Method:

All patients treated with the Inspire system in our clinic during the 2013 – 2016 period were screened for all previous OSA surgeries. Subjective (ESS) and respiratory (AHI) parameters were recorded. Data from patients with and without previous surgery were compared.

Results:

Of 65 patients, 14 patients (13 m and 1f, age 56.71 ± 6.94 years, BMI 27.11 ± 2.27 kg/m2) underwent surgery prior to implantation. All 14 patients had an intervention on the soft palate. In 7 of the 14 patients, interventions on the tongue had been performed. The interval between initial surgery and implantation of the stimulation therapy was between 6 and 120 months.

The AHI in all 14 patients changed from 43.46 ± 25.49/h (n = 9) before initial surgery to 38.09 ± 15.02/h (n = 14) before implantation to 11.51 ± 6.54/h (n = 14) after implantation. In 57.1% of cases with exclusive soft palate surgery, a reduction of AHI below 15/h under stimulation was found. The AHI returned to 10.87 ± 7.46/h by stimulation from 31.59 ± 8.09/h. In patients undergoing interventions involving the basic tongue, the AHI was reduced from 71.4% to under 15/h. The average AHI in this group decreased from 44.59 ± 19.03/h before to 12.14 ± 6.02/h with stimulation.

Conclusion:

Our analysis indicates that previous operations to treat obstructive sleep apnea have no impact on the success rate of upper airway stimulation.

Publication History

Publication Date:
18 April 2018 (online)