Comparison of Traditional Upper Airway Surgery and Upper Airway Stimulation for Obstructive Sleep Apnea.

Huntley, Colin; Boon, Maurits; Tschopp, Samuel; Tschopp, Kurt; Jenks, Carolyn M; Thaler, Erica; Baptista Jardin, Peter; Shah, Janki; Kominsky, Alan; Kezirian, Eric J; Heiser, Clemens; Waxman, Jonathan; Lin, Ho-Sheng (2021). Comparison of Traditional Upper Airway Surgery and Upper Airway Stimulation for Obstructive Sleep Apnea. Annals of otology, rhinology & laryngology, 130(4), pp. 370-376. Sage 10.1177/0003489420953178

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OBJECTIVE

To compare patients with moderate-severe obstructive sleep apnea (OSA) undergoing traditional single and multilevel sleep surgery to those undergoing upper airway stimulation (UAS).

STUDY DESIGN

Case control study comparing retrospective cohort of patients undergoing traditional sleep surgery to patients undergoing UAS enrolled in the ADHERE registry.

SETTING

8 multinational academic medical centers.

SUBJECTS AND METHODS

233 patients undergoing prior single or multilevel traditional sleep surgery and meeting study inclusion criteria were compared to 465 patients from the ADHERE registry who underwent UAS. We compared preoperative and postoperative demographic, quality of life, and polysomnographic data. We also evaluated treatment response rates.

RESULTS

The pre and postoperative apnea hypopnea index (AHI) was 33.5 and 15 in the traditional sleep surgery group and 32 and 10 in the UAS group. The postoperative AHI in the UAS group was significantly lower. The pre and postoperative Epworth sleepiness scores (ESS) were 12 and 6 in both the traditional sleep surgery and UAS groups. Subgroup analysis evaluated those patients undergoing single level palate and multilevel palate and tongue base traditional sleep surgeries. The UAS group had a significantly lower postoperive AHI than both traditional sleep surgery subgroups. The UAS group had a higher percentage of patients reaching surgical success, defined as a postoperative AHI <20 with a 50% reduction from preoperative severity.

CONCLUSION

UAS offers significantly better control of AHI severity than traditional sleep surgery. Quality life improvements were similar between groups.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT)

UniBE Contributor:

Tschopp, Samuel

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1943-572X

Publisher:

Sage

Language:

English

Submitter:

Stefan Weder

Date Deposited:

19 Jan 2021 11:52

Last Modified:

10 Mar 2021 01:33

Publisher DOI:

10.1177/0003489420953178

PubMed ID:

32862654

Uncontrolled Keywords:

Otolaryngology Rhinology obstructive sleep apnea sleep apnea sleep disordered breathing sleep medicine sleep surgery

URI:

https://boris.unibe.ch/id/eprint/150349

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