Study Objectives: Hypoglossal nerve stimulation (HGNS) has been widely used to treat obstructive sleep apnea in selected patients. Here we evaluate rates of revision and explant related to HGNS implantation and assess types of adverse events contributing to revision and explant.
Methods: Postmarket surveillance data for HGNS implanted between January 1, 2018 and March 31, 2022, were collected. Event rates and risk were calculated using the postmarket surveillance event counts and sales volume over the same period. Indications were categorized for analysis. Descriptive statistics were reported and freedom from explant or revision curves were grouped by year of implantation.
Results: Of the 20,881 HGNS implants assessed, rates of explant and revision within the first year were 0.723% and 1.542%, respectively. The most common indication for explant was infection (0.378%) and for revision was surgical correction (0.680%). Of the 5,820 devices with 3-year postimplantation data, the rate of explant was 2.680% and of revision was 3.557%. During this same interval, elective removal (1.478%) was the most common indication, and for revisions, surgical correction (1.134%).
Conclusions: The efficacy of HGNS is comparable in the real world setting to published clinical trial data. Rates of explant and revision are low, supporting a satisfactory safety profile for this technology.
Citation: Moroco AE, Wei Z, Byrd I, et al. Device-related outcomes following hypoglossal nerve stimulator implantation. . 2024;20(9):1497-1503.
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http://dx.doi.org/10.5664/jcsm.11176 | DOI Listing |
Brain Spine
December 2024
Department of Neurosurgery, Johann Wolfgang Goethe University Hospital, Frankfurt, Germany.
Introduction: Breathing-synchronized hypoglossal-nerve stimulation is a treatment option for suitable patients with severe obstructive-sleep-apnoea. The classical implantation technique requires three incisions: submental to place the stimulating-electrode on terminal branches of the hypoglossal-nerve, sub-clavicular to place the impulse generator, and on the lateral chest-wall to place a breathing-sensor lead. A two-incision-technique has been propagated and widely adopted whereby the respiratory-sensing-lead is placed deeper to the IPG-pocket.
View Article and Find Full Text PDFOtolaryngol Head Neck Surg
January 2025
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Objective: To compare the incidence of motor vehicle accidents (MVAs) among patients with obstructive sleep apnea (OSA) undergoing continuous positive airway pressure (CPAP) therapy and sleep surgery.
Study Design: Retrospective cohort study using the TriNetX national clinical database.
Setting: Analysis of a nationwide patient cohort.
J Anat
January 2025
Graduate School of Medicine, Juntendo University, Tokyo, Japan.
The anatomical innovation of sound-producing organs, which gives rise to a wide variety of sound signals, is one of the most fundamental factors leading to the explosive speciation of modern birds. Despite being a key clue to resolving the homology of sound-controlling muscles among birds, only few studies have explored the embryonic development of syringeal muscles. Using serial histological sections and immunohistochemistry, we described the three-dimensional anatomy and development of the cartilage, muscle, and innervation pattern of the tracheobronchi in three avian species: domestic fowls, cockatiels, and zebra finches.
View Article and Find Full Text PDFLaryngoscope Investig Otolaryngol
February 2025
Objectives: Hypoglossal nerve stimulation (HGNS) is a promising surgical option for patients with obstructive sleep apnea (OSA) who are intolerant of continuous positive airway pressure therapy (CPAP). Efficacy studies for HGNS stimulation largely focus on the apnea-hypopnea index and/or oxygen desaturation index. This study's objective was to show the physiological effects of HGNS stimulation on upper airway patency, airflow, and treatment effect during polysomnography (PSG) testing.
View Article and Find Full Text PDFJ Oral Maxillofac Surg
December 2024
Chief Resident, University of Minnesota, Minneapolis, MN; Associate Surgeon, Oral and Maxillofacial Surgical Consultants, Minneapolis, MN. Electronic address:
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