Skip to main content Accessibility help
×
Home
Hostname: page-component-cf9d5c678-gf4tf Total loading time: 0.352 Render date: 2021-08-03T14:05:29.072Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Short-term results of upper airway stimulation in obstructive sleep apnoea patients: the Amsterdam experience

Published online by Cambridge University Press:  03 June 2020

P E Vonk
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Onze Lieve Vrouwe Gasthuis (‘OLVG’), Amsterdam, the Netherlands Department of Otorhinolaryngology – Head and Neck Surgery, Amsterdam UMC, location AMC, the Netherlands
M J L Ravesloot
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Onze Lieve Vrouwe Gasthuis (‘OLVG’), Amsterdam, the Netherlands Department of Otorhinolaryngology, Medical Centre Jan van Goyen, Amsterdam, the Netherlands
J P van Maanen
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Onze Lieve Vrouwe Gasthuis (‘OLVG’), Amsterdam, the Netherlands
N de Vries
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Onze Lieve Vrouwe Gasthuis (‘OLVG’), Amsterdam, the Netherlands Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam, MOVE Research Institute Amsterdam, University of Amsterdam and Vrije Universiteit University Amsterdam, the Netherlands Faculty of Medicine and Health Sciences, Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Belgium
Corresponding
E-mail address:
Get access

Abstract

Objectives

This paper aimed to: retrospectively analyse single-centre results in terms of surgical success, respiratory outcomes and adverse events after short-term follow up in obstructive sleep apnoea patients treated with upper airway stimulation; and evaluate the correlation between pre-operative drug-induced sleep endoscopy findings and surgical success.

Methods

A retrospective descriptive cohort study was conducted, including a consecutive series of obstructive sleep apnoea patients undergoing implantation of an upper airway stimulation system.

Results

Forty-four patients were included. The total median Apnoea–Hypopnea Index and oxygen desaturation index significantly decreased from 37.6 to 8.3 events per hour (p < 0.001) and from 37.1 to 15.9 events per hour (p < 0.001), respectively. The surgical success rate was 88.6 per cent, and did not significantly differ between patients with or without complete collapse at the retropalatal level (p = 0.784). The most common therapy-related adverse event reported was (temporary) stimulation-related discomfort.

Conclusion

Upper airway stimulation is an effective and safe treatment in obstructive sleep apnoea patients with continuous positive airway pressure intolerance or failure. There was no significant difference in surgical outcome between patients with tongue base collapse with or without complete anteroposterior collapse at the level of the palate.

Type
Main Articles
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr P E Vonk takes responsibility for the integrity of the content of the paper

References

Rotenberg, BW, Vicini, C, Pang, EB, Pang, KP. Reconsidering first-line treatment for obstructive sleep apnea: a systematic review of the literature. J Otolaryngol Head Neck Surg 2016;45:23CrossRefGoogle ScholarPubMed
Heiser, C, Edenharter, G, Bas, M, Wirth, M, Hofauer, B. Palatoglossus coupling in selective upper airway stimulation. Laryngoscope 2017;127:E378–83CrossRefGoogle ScholarPubMed
Boon, M, Huntley, C, Steffen, A, Maurer, JT, Sommer, JU, Schwab, R et al. Upper airway stimulation for obstructive sleep apnea: results from the ADHERE registry. Otolaryngol Head Neck Surg 2018;159:379–85CrossRefGoogle ScholarPubMed
Heiser, C, Knopf, A, Bas, M, Gahleitner, C, Hofauer, B. Selective upper airway stimulation for obstructive sleep apnea: a single center clinical experience. Eur Arch Otorhinolaryngol 2017;274:1727–34CrossRefGoogle ScholarPubMed
Kent, DT, Lee, JJ, Strollo, PJ Jr, Soose, RJ. Upper airway stimulation for OSA: early adherence and outcome results of one center. Otolaryngol Head Neck Surg 2016;155:188–93CrossRefGoogle ScholarPubMed
Steffen, A, Hartmann, JT, Konig, IR, Ravesloot, MJL, Hofauer, B, Heiser, C. Evaluation of body position in upper airway stimulation for obstructive sleep apnea--is continuous voltage sufficient enough? Sleep Breath 2018;22:1207–12CrossRefGoogle ScholarPubMed
Steffen, A, Sommer, JU, Hofauer, B, Maurer, JT, Hasselbacher, K, Heiser, C. Outcome after one year of upper airway stimulation for obstructive sleep apnea in a multicenter German post-market study. Laryngoscope 2018;128:509–1510.1002/lary.26688CrossRefGoogle Scholar
Woodson, BT, Soose, RJ, Gillespie, MB, Strohl, KP, Maurer, JT, de Vries, N et al. Three-year outcomes of cranial nerve stimulation for obstructive sleep apnea: the STAR trial. Otolaryngol Head Neck Surg 2016;154:181–8CrossRefGoogle ScholarPubMed
Strollo, PJ Jr, Gillespie, MB, Soose, RJ, Maurer, JT, de Vries, N, Cornelius, J et al. Upper airway stimulation for obstructive sleep apnea: durability of the treatment effect at 18 months. Sleep 2015;38:1593–8Google ScholarPubMed
Strollo, PJ Jr, Soose, RJ, Maurer, JT, de Vries, N, Cornelius, J, Froymovich, O et al. Upper-airway stimulation for obstructive sleep apnea. N Engl J Med 2014;370:139–49CrossRefGoogle ScholarPubMed
Woodson, BT, Gillespie, MB, Soose, RJ, Maurer, JT, De Vries, N, Steward, DL et al. Randomized controlled withdrawal study of upper airway stimulation on OSA: short- and long-term effect. Otolaryngol Head Neck Surg 2014;151:880–7CrossRefGoogle ScholarPubMed
Woodson, BT, Strohl, KP, Soose, RJ, Gillespie, MB, Maurer, JT, de Vries, N et al. Upper airway stimulation for obstructive sleep apnea: 5-year outcomes. Otolaryngol Head Neck Surg 2018;159:194202CrossRefGoogle ScholarPubMed
Vanderveken, OM, Maurer, JT, Hohenhorst, W, Hamans, E, Lin, HS, Vroegop, AV et al. Evaluation of drug-induced sleep endoscopy as a patient selection tool for implanted upper airway stimulation for obstructive sleep apnea. J Clin Sleep Med 2013;9:433–8CrossRefGoogle ScholarPubMed
Schnider, TW, Minto, CF, Gambus, PL, Andresen, C, Goodale, DB, Shafer, SL et al. The influence of method of administration and covariates on the pharmacokinetics of propofol in adult volunteers. Anesthesiology 1998;88:1170–82CrossRefGoogle ScholarPubMed
Schnider, T, Minto, C. Pharmacokinetic models of propofol for TCI. Anaesthesia 2008;63:206CrossRefGoogle ScholarPubMed
Kezirian, EJ, Hohenhorst, W, de Vries, N. Drug-induced sleep endoscopy: the VOTE classification. Eur Arch Otorhinolaryngol 2011;268:1233–6CrossRefGoogle ScholarPubMed
Sher, AE, Schechtman, KB, Piccirillo, JF. The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome. Sleep 1996;19:156–77Google ScholarPubMed
Berry, RB, Budhiraja, R, Gottlieb, DJ, Gozal, D, Iber, C, Kapur, VK et al. Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med 2012;8:597619CrossRefGoogle ScholarPubMed
Heiser, C, Maurer, JT, Hofauer, B, Sommer, JU, Seitz, A, Steffen, A. Outcomes of upper airway stimulation for obstructive sleep apnea in a multicenter German postmarket study. Otolaryngol Head Neck Surg 2017;156:378–84CrossRefGoogle Scholar
Mahmoud, AF, Thaler, ER. Outcomes of hypoglossal nerve upper airway stimulation among patients with isolated retropalatal collapse. Otolaryngol Head Neck Surg 2019;160:1124–9CrossRefGoogle ScholarPubMed
Yaggi, HK, Concato, J, Kernan, WN, Lichtman, JH, Brass, LM, Mohsenin, V. Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med 2005;353:2034–41CrossRefGoogle ScholarPubMed
Good, DC, Henkle, JQ, Gelber, D, Welsh, J, Verhulst, S. Sleep-disordered breathing and poor functional outcome after stroke. Stroke 1996;27:252–9CrossRefGoogle ScholarPubMed
Parra, O, Arboix, A, Montserrat, J, Quinto, L, Bechich, S, Garcia-Eroles, L. Sleep-related breathing disorders: impact on mortality of cerebrovascular disease. Eur Respir J 2004;24:267–72CrossRefGoogle ScholarPubMed
Parra, O, Sánchez-Armengol, Á, Capote, F, Bonnin, M, Arboix, A, Campos-Rodríguez, F et al. Efficacy of continuous positive airway pressure treatment on 5-year survival in patients with ischaemic stroke and obstructive sleep apnea: a randomized controlled trial. J Sleep Res 2015;24:4753CrossRefGoogle ScholarPubMed
Kezirian, EJ, Goldberg, AN. Hypopharyngeal surgery in obstructive sleep apnea: an evidence-based medicine review. Arch Otolaryngol Head Neck Surg 2006;132:206–13CrossRefGoogle Scholar
Ravesloot, MJ, de Vries, N. Reliable calculation of the efficacy of non-surgical and surgical treatment of obstructive sleep apnea revisited. Sleep 2011;34:105–10CrossRefGoogle ScholarPubMed
1
Cited by

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Short-term results of upper airway stimulation in obstructive sleep apnoea patients: the Amsterdam experience
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Short-term results of upper airway stimulation in obstructive sleep apnoea patients: the Amsterdam experience
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Short-term results of upper airway stimulation in obstructive sleep apnoea patients: the Amsterdam experience
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *