Pub Date : 2021-01-01DOI: 10.1093/med/9780197521625.003.0012
M. Boon, C. Huntley
Upper airway stimulation (UAS) has emerged as a viable alternative to treat obstructive sleep apnea in select patients who cannot tolerate continuous positive airway pressure. This chapter discusses special populations and circumstances that may impact care of patients using UAS. Topics addressed include women receiving implants, patients with Down syndrome, left-sided implants, replacement of an internal pulse generator, revision surgery, use of UAS with other implanted medical devices, and implants outside of indications approved by the U.S. Food and Drug Administration. Evidence is provided where applicable, but for many of the situations detailed, limited published data are available; the information provided represents consensus and expert opinion.
{"title":"Special Circumstances","authors":"M. Boon, C. Huntley","doi":"10.1093/med/9780197521625.003.0012","DOIUrl":"https://doi.org/10.1093/med/9780197521625.003.0012","url":null,"abstract":"Upper airway stimulation (UAS) has emerged as a viable alternative to treat obstructive sleep apnea in select patients who cannot tolerate continuous positive airway pressure. This chapter discusses special populations and circumstances that may impact care of patients using UAS. Topics addressed include women receiving implants, patients with Down syndrome, left-sided implants, replacement of an internal pulse generator, revision surgery, use of UAS with other implanted medical devices, and implants outside of indications approved by the U.S. Food and Drug Administration. Evidence is provided where applicable, but for many of the situations detailed, limited published data are available; the information provided represents consensus and expert opinion.","PeriodicalId":339325,"journal":{"name":"Upper Airway Stimulation Therapy for Obstructive Sleep Apnea","volume":"120 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123577803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.1093/MED/9780197521625.003.0013
E. Thaler, J. Rodin
This chapter, written from the perspective of an otorhinolaryngologist/head and neck surgeon, discusses the practical aspects involved in creating a successful multidisciplinary program to provide upper airway stimulation therapy for patients with obstructive sleep apnea. Topics covered are critical professional elements, including proper education and training; the importance of multidisciplinary professional collaboration; how best to develop an integrated approach; and the optimal administrative approach. Economic considerations and cost-effectiveness information relevant to this therapy are also discussed. The goal is to guide the interested practitioner in building a robust program providing upper airway stimulation therapy that will be adaptable to future technological innovation in this burgeoning field.
{"title":"Practical Aspects of Initiating and Maintaining a Multidisciplinary Program","authors":"E. Thaler, J. Rodin","doi":"10.1093/MED/9780197521625.003.0013","DOIUrl":"https://doi.org/10.1093/MED/9780197521625.003.0013","url":null,"abstract":"This chapter, written from the perspective of an otorhinolaryngologist/head and neck surgeon, discusses the practical aspects involved in creating a successful multidisciplinary program to provide upper airway stimulation therapy for patients with obstructive sleep apnea. Topics covered are critical professional elements, including proper education and training; the importance of multidisciplinary professional collaboration; how best to develop an integrated approach; and the optimal administrative approach. Economic considerations and cost-effectiveness information relevant to this therapy are also discussed. The goal is to guide the interested practitioner in building a robust program providing upper airway stimulation therapy that will be adaptable to future technological innovation in this burgeoning field.","PeriodicalId":339325,"journal":{"name":"Upper Airway Stimulation Therapy for Obstructive Sleep Apnea","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133839740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.1093/med/9780197521625.003.0006
E. Kezirian, M. Ravesloot, W. Hohenhorst, N. de Vries
Drug-induced sleep endoscopy (DISE) is an upper airway evaluation technique in which fiberoptic examination is performed under conditions of unconscious sedation. Unique information obtained from this three-dimensional examination of the airway potentially provides additive benefits to other evaluation methods to guide treatment selection. This chapter presents recommendations regarding DISE technique. It presents the Velum, Oropharynx, Tongue Base, Epiglottis (VOTE) classification for reporting DISE findings, which incorporates the four major structures that contribute to airway obstruction in most patients. The authors review the evidence concerning DISE test characteristics and the association between DISE findings and treatment outcomes, including for upper airway stimulation.
{"title":"Drug-Induced Sleep Endoscopy","authors":"E. Kezirian, M. Ravesloot, W. Hohenhorst, N. de Vries","doi":"10.1093/med/9780197521625.003.0006","DOIUrl":"https://doi.org/10.1093/med/9780197521625.003.0006","url":null,"abstract":"Drug-induced sleep endoscopy (DISE) is an upper airway evaluation technique in which fiberoptic examination is performed under conditions of unconscious sedation. Unique information obtained from this three-dimensional examination of the airway potentially provides additive benefits to other evaluation methods to guide treatment selection. This chapter presents recommendations regarding DISE technique. It presents the Velum, Oropharynx, Tongue Base, Epiglottis (VOTE) classification for reporting DISE findings, which incorporates the four major structures that contribute to airway obstruction in most patients. The authors review the evidence concerning DISE test characteristics and the association between DISE findings and treatment outcomes, including for upper airway stimulation.","PeriodicalId":339325,"journal":{"name":"Upper Airway Stimulation Therapy for Obstructive Sleep Apnea","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129793475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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