Safety and Effectiveness of Upper Airway Stimulation via the Hypoglossal Nerve for Obstructive Sleep Apnea

This case demonstrates the first successful treatment of obstructive sleep apnea with hypoglossal nerve upper airway stimulation in a patient with prior radiation for oropharynx cancer complicated by osteoradionecrosis of the mandible.

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Randomized Controlled Withdrawal Study of Upper Airway Stimulation on OSA

Otolaryngology ◽

10.1177/0194599814544445 ◽

2014 ◽

Vol 151 (5) ◽

pp. 880-887 ◽

Cited By ~ 74

Author(s):

B. Tucker Woodson ◽

M. Boyd Gillespie ◽

Ryan J. Soose ◽

Joachim T. Maurer ◽

Nico de Vries ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Outcome Measures ◽

Hypoglossal Nerve ◽

Upper Airway ◽

Oxygen Desaturation ◽

Upper Airway Stimulation ◽

Randomized Controlled ◽

Obstructive Sleep ◽

Therapy Withdrawal

Objective To assess the efficacy and durability of upper airway stimulation via the hypoglossal nerve on obstructive sleep apnea (OSA) severity including objective and subjective clinical outcome measures. Study Design A randomized controlled therapy withdrawal study. Setting Industry-supported multicenter academic and clinical setting. Subjects A consecutive cohort of 46 responders at 12 months from a prospective phase III trial of 126 implanted participants. Methods Participants were randomized to either therapy maintenance (“ON”) group or therapy withdrawal (“OFF”) group for a minimum of 1 week. Short-term withdrawal effect as well as durability at 18 months of primary (apnea hypopnea index and oxygen desaturation index) and secondary outcomes (arousal index, oxygen desaturation metrics, Epworth Sleepiness Scale, Functional Outcomes of Sleep Questionnaire, snoring, and blood pressure) were assessed. Results Both therapy withdrawal group and maintenance group demonstrated significant improvements in outcomes at 12 months compared to study baseline. In the randomized assessment, therapy withdrawal group returned to baseline, and therapy maintenance group demonstrated no change. At 18 months with therapy on in both groups, all objective respiratory and subjective outcome measures showed sustained improvement similar to those observed at 12 months. Conclusion Withdrawal of therapeutic upper airway stimulation results in worsening of both objective and subjective measures of sleep and breathing, which when resumed results in sustained effect at 18 months. Reduction of obstructive sleep apnea severity and improvement of quality of life were attributed directly to the effects of the electrical stimulation of the hypoglossal nerve.

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Upper Airway Stimulation in the Management of Obstructive Sleep Apnea Syndrome: Neurostimulation of Hypoglossal Nerve

International Journal of Head and Neck Surgery ◽

10.5005/jp-journals-10001-1381 ◽

2019 ◽

Vol 10 (4) ◽

pp. 77-85

Author(s):

Peter Baptista ◽

Carlos Prieto ◽

Octavio Garaycochea

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Obstructive Sleep Apnea Syndrome ◽

Hypoglossal Nerve ◽

Sleep Apnea Syndrome ◽

Upper Airway ◽

Upper Airway Stimulation ◽

Obstructive Sleep ◽

Apnea Syndrome

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Upper Airway Stimulation Therapy for Obstructive Sleep Apnea

10.1093/med/9780197521625.001.0001 ◽

2021 ◽

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Upper Airway ◽

Novel Therapy ◽

Upper Airway Stimulation ◽

Current State ◽

Obstructive Sleep ◽

Long Term Follow Up ◽

Physician Extenders ◽

Primary Care Practitioners

Upper Airway Stimulation Therapy for Obstructive Sleep Apnea provides the current state of knowledge regarding this novel therapy. It reviews the pathophysiologic basis of sleep apnea and the specific mechanism by which upper airway stimulation provides airway support in this disorder. It also provides practical insights into this therapy related to patient selection, clinical outcomes, surgical technique, long-term follow-up, and adverse events and offers recommendations for those aspiring to develop an upper airway stimulation program. It provides an overview of unique populations and circumstances that may extend the utility of the procedure, and that may provide challenges in management, as well as thoughts on the future of this technology. This textbook is intended for all practitioners who have interest or care for sleep disordered breathing, including sleep medicine physicians, pulmonologists, otolaryngologists, primary care practitioners, as well as physician extenders.

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