PMID- 37538037
OWN - NLM
STAT- MEDLINE
DCOM- 20231122
LR  - 20231122
IS  - 1097-6817 (Electronic)
IS  - 0194-5998 (Linking)
VI  - 169
IP  - 6
DP  - 2023 Dec
TI  - Hypoglossal Nerve Stimulation Therapy Outcomes in Apnea- Versus 
      Hypopnea-Predominant Patients.
PG  - 1674-1682
LID - 10.1002/ohn.464 [doi]
AB  - OBJECTIVES: The influence of apnea- and hypopnea-predominance on hypoglossal 
      nerve stimulation therapy outcomes (HGNS) is still poorly defined. We assessed 
      the significance of apnea- and hypopnea-predominance in HGNS outcomes. STUDY 
      DESIGN: Case series with chart review. SETTING: Single-institution tertiary care 
      center. METHODS: A total of 216 subjects were included, all of which had 
      undergone drug-induced sleep endoscopy (DISE) and HGNS implantation. Demographic 
      and polysomnographic data were collected. The 4% apnea-hypopnea criteria were 
      used to calculate apnea-hypopnea index (AHI). Central apneas were omitted. 
      Univariate logistic and linear regression were used to study the association 
      between these data and apnea-predominance and hypopnea-predominance. 
      Kruskal-Wallis rank sum test was used to compare medians between groups for DISE 
      collapse patterns. RESULTS: Sixty-three patients were apnea-predominant, and 153 
      patients were hypopnea-predominant. These 2 groups were similar demographically 
      (p > .20). There was no significant difference in HGNS outcomes between the 
      groups assessed using Sher20 criteria at the 1-year mark using all-night, 
      single-setting polysomnography or home sleep studies. Apnea index (AI)/AHI and 
      reduction in AHI from preoperative to titration were significantly associated 
      (p = .046). The median preoperative hypopnea index was significantly lower 
      (p = .033) in subjects with no oropharyngeal collapse than patients with partial 
      or complete oropharyngeal collapse. There were no significant relationships 
      between AI/AHI and the different degrees of collapse at the velopharynx, 
      oropharynx, tongue base, or epiglottis. CONCLUSIONS: In line with CPAP, 
      tonsillectomy, and mandibular advancement therapy studies, we found there was 
      largely no significant difference in DISE anatomy or in HGNS treatment outcomes 
      between apnea- and hypopnea-predominant individuals.
CI  - (c) 2023 The Authors. Otolaryngology-Head and Neck Surgery published by Wiley 
      Periodicals LLC on behalf of American Academy of Otolaryngology-Head and Neck 
      Surgery Foundation.
FAU - Gao, Thomas Z
AU  - Gao TZ
AUID- ORCID: 0000-0001-8053-1378
AD  - College of Medicine, The Ohio State University, Columbus, Ohio, USA.
FAU - Ma, Jianing
AU  - Ma J
AD  - Department of Biomedical Informatics, The Ohio State University, Columbus, Ohio, 
      USA.
FAU - Hall, Daniel
AU  - Hall D
AD  - Department of Otolaryngology-Head and Neck Surgery, The Ohio State University 
      Wexner Medical Center, Columbus, OH, USA.
FAU - Pan, Xueliang
AU  - Pan X
AD  - Department of Biomedical Informatics, The Ohio State University, Columbus, Ohio, 
      USA.
FAU - Rings, Vijay K
AU  - Rings VK
AD  - Boonshoft School of Medicine, Wright State University, Dayton, Ohio, USA.
FAU - Zia, Ali
AU  - Zia A
AD  - College of Medicine and Life Sciences, Toledo University, Toledo, Ohio, USA.
FAU - Harris, Micah K
AU  - Harris MK
AD  - College of Medicine, The Ohio State University, Columbus, Ohio, USA.
FAU - Chio, Eugene G
AU  - Chio EG
AD  - Department of Otolaryngology-Head and Neck Surgery, The Ohio State University 
      Wexner Medical Center, Columbus, OH, USA.
LA  - eng
PT  - Journal Article
DEP - 20230804
PL  - England
TA  - Otolaryngol Head Neck Surg
JT  - Otolaryngology--head and neck surgery : official journal of American Academy of 
      Otolaryngology-Head and Neck Surgery
JID - 8508176
SB  - IM
MH  - Humans
MH  - *Sleep Apnea, Obstructive/therapy/surgery
MH  - Hypoglossal Nerve
MH  - Endoscopy
MH  - Polysomnography
MH  - Treatment Outcome
OTO - NOTNLM
OT  - drug-induced sleep endoscopy
OT  - hypoglossal nerve stimulator
OT  - phenotype
OT  - sleep medicine
OT  - sleep surgery
EDAT- 2023/08/04 06:43
MHDA- 2023/11/22 06:43
CRDT- 2023/08/04 03:43
PHST- 2023/06/15 00:00 [revised]
PHST- 2023/02/10 00:00 [received]
PHST- 2023/07/14 00:00 [accepted]
PHST- 2023/11/22 06:43 [medline]
PHST- 2023/08/04 06:43 [pubmed]
PHST- 2023/08/04 03:43 [entrez]
AID - 10.1002/ohn.464 [doi]
PST - ppublish
SO  - Otolaryngol Head Neck Surg. 2023 Dec;169(6):1674-1682. doi: 10.1002/ohn.464. Epub 
      2023 Aug 4.