Bilateral Hypoglossal Nerve Stimulation Shows Favorable Treatment Response in Patients With Oropharyngeal Lateral Wall Collapse

Saturday, September 28, 2024

4:12 PM – 4:18 PM EDT

Location: MBCC, 238-239

Disclosure(s):

Daniel Ph Jira, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Anne Ruck:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

J. Ulrich Sommer, MD, PhD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Clemens Heiser, MD, PhD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Hypoglossal nerve stimulation is an established treatment option for patients with OSA. Recent findings suggest that a complete lateral wall collapse at the oropharyngeal level during preoperative drug-induced sleep endoscopy may be linked to a less positive response to hypoglossal nerve stimulation. Given the positive outcomes observed in patients with a complete concentric collapse at the level of the soft palate with bilateral hypoglossal nerve stimulation, our investigation aimed to determine whether individuals experiencing a complete lateral collapse of the oropharyngeal wall could also derive benefits from this therapy.

Methods: We enrolled 28 patients in the study, which were treated with bilateral hypoglossal nerve stimulation (Genio-system, Nyxoah S.A., Belgium). All patients underwent implantation between 2020 and 2023 at Klinikum rechts der Isar, Technical University Munich, Germany. Polysomnography was performed to evaluate respiratory outcome parameters 6 and 12 months after surgery, respectively.

Results: In total, a complete lateral wall collapse at the oropharyngeal level was shown in 5 out of 28 patients (17.9%). At a 6-month follow up, 3 out of 5 patients (60%) were responders to the therapy according to Sher-criteria, at month 12 PSG four out of 5 patients (80%) were classified as responders.
In responders, median AHI was reduced from 28.0/h at baseline to 10.1/h after one year.

Conclusions: In this analysis of a small patient group, we demonstrated that bilateral hypoglossal nerve stimulation can serve as an effective treatment for obstructive sleep apnea (OSA) in individuals with a complete collapse of the lateral oropharyngeal wall. The findings suggest that bilateral hypoglossal nerve stimulation could be a viable therapeutic option for patients with this particular type of upper airway obstruction.

Presenting Author(s)

Daniel Ph Jira, MD

Specialist for Otolaryngology/Head and neck surgery, Clinical head of ENT sleep lab
Otolaryngology/Head and neck surgery, Klinikum Rechts der Isar, Technical University Munich
Munich, Bayern, Germany

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

ZZ

Zhaojun Zhu, MD

Otolaryngology/Head and neck surgery, Klinikum Rechts der Isar, Technical University Munich, United States

Disclosure information not submitted.
Anne Ruck

Resident
Klinikum Rechts der Isar, Technical University Munich
Munich, Bayern, Germany

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
J. Ulrich Sommer, MD, PhD

Professor and ENT, Head and Neck Surgeon
Technical University Munich
München, Bayern, Germany

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

Clemens Heiser, MD, PhD

Professor and ENT, Head and Neck Surgeon
Technical University of Munich
Munich, Bayern, Germany

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.