Using Postactivation Adjustment as a Marker for Inferior Outcomes in Hypoglossal Nerve Stimulator Patients.

IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY Otolaryngology- Head and Neck Surgery Pub Date : 2024-12-22 DOI:10.1002/ohn.1100
Andrew Corr, Elliott M Sina, Erin Creighton, Nicolo Bautista, Megha Chandna, Maurits Boon, Colin Huntley
{"title":"Using Postactivation Adjustment as a Marker for Inferior Outcomes in Hypoglossal Nerve Stimulator Patients.","authors":"Andrew Corr, Elliott M Sina, Erin Creighton, Nicolo Bautista, Megha Chandna, Maurits Boon, Colin Huntley","doi":"10.1002/ohn.1100","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to examine differences in postoperative outcomes between patients requiring postactivation adjustment and those who do not, within a cohort of patients undergoing hypoglossal nerve stimulation (HGNS) for obstructive sleep apnea (OSA).</p><p><strong>Study design: </strong>Retrospective database analysis.</p><p><strong>Setting: </strong>Single-institution, academic center.</p><p><strong>Methods: </strong>We reviewed patients undergoing HGNS placement for OSA from January 2020 to December 2021. Adjustment visits were defined as any visit that occurred after the initial activation of the device but before postoperative sleep study, including modification of the HGNS device settings (stimulation voltage, configuration, pulse width, rate, start, and pause delay). Primary outcome measures included postoperative apnea-hypopnea index (AHI) and O<sub>2</sub> nadir collected via a sleep study. Secondary aims included identifying significant predictors of needing postactivation adjustment.</p><p><strong>Results: </strong>Of 116 patients undergoing HGNS placement, 30 (25.6%) required postactivation adjustment. These patients had a higher average postoperative AHI of 21.3, compared to 12.5 in those who did not undergo adjustments (P = .002). Additionally, adjustment patients had a significantly lower postoperative O<sub>2</sub> nadir (82% vs 85%; P = .009). A higher baseline body mass index was observed in patients requiring adjustments (29.4 vs 28.3; P = .047). Decreasing sleep latency and increasing total VOTE score on drug-induced sleep endoscopy were significant predictors of needing postactivation adjustment (P = .046, .014).</p><p><strong>Conclusion: </strong>Patients experiencing early postactivation HGNS intolerance, requiring device adjustment, have significantly poorer long-term surgical sleep outcomes for OSA. Early identification of this cohort is crucial to optimizing treatment for those less responsive to HGNS therapy.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Otolaryngology- Head and Neck Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ohn.1100","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: This study aimed to examine differences in postoperative outcomes between patients requiring postactivation adjustment and those who do not, within a cohort of patients undergoing hypoglossal nerve stimulation (HGNS) for obstructive sleep apnea (OSA).

Study design: Retrospective database analysis.

Setting: Single-institution, academic center.

Methods: We reviewed patients undergoing HGNS placement for OSA from January 2020 to December 2021. Adjustment visits were defined as any visit that occurred after the initial activation of the device but before postoperative sleep study, including modification of the HGNS device settings (stimulation voltage, configuration, pulse width, rate, start, and pause delay). Primary outcome measures included postoperative apnea-hypopnea index (AHI) and O2 nadir collected via a sleep study. Secondary aims included identifying significant predictors of needing postactivation adjustment.

Results: Of 116 patients undergoing HGNS placement, 30 (25.6%) required postactivation adjustment. These patients had a higher average postoperative AHI of 21.3, compared to 12.5 in those who did not undergo adjustments (P = .002). Additionally, adjustment patients had a significantly lower postoperative O2 nadir (82% vs 85%; P = .009). A higher baseline body mass index was observed in patients requiring adjustments (29.4 vs 28.3; P = .047). Decreasing sleep latency and increasing total VOTE score on drug-induced sleep endoscopy were significant predictors of needing postactivation adjustment (P = .046, .014).

Conclusion: Patients experiencing early postactivation HGNS intolerance, requiring device adjustment, have significantly poorer long-term surgical sleep outcomes for OSA. Early identification of this cohort is crucial to optimizing treatment for those less responsive to HGNS therapy.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
求助全文
约1分钟内获得全文 去求助
来源期刊
Otolaryngology- Head and Neck Surgery
Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学
CiteScore
6.70
自引率
2.90%
发文量
250
审稿时长
2-4 weeks
期刊介绍: Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.
期刊最新文献
Comparison of IL-1 Receptor Antagonist and Dexamethasone in Noise-Induced Hearing Loss: Animal Model. Positive Margin Rates in Oral Cavity and Oropharyngeal Malignancies: A National Analysis. Radiological Sublingual Space Invasion in Tongue Squamous Cell Carcinoma: Clinicopathological Associations and Impact on Survival. Time-Drive Activity-Based Costing (TDABC) in Otolaryngology: A Scoping Review. Using Postactivation Adjustment as a Marker for Inferior Outcomes in Hypoglossal Nerve Stimulator Patients.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1