The Darker Side of Sleep: Suboptimal Outcomes, Side Effects, and Complications of Hypoglossal Nerve Stimulation

Sunday, September 29, 2024

1:00 PM – 2:00 PM EDT

Location: MBCC, 238-239

CME/MOC Credit: 1

Disclosure(s):

Marion B. Gillespie, MD:

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

Maria V. Suurna, MD:

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

Colin T. Huntley, MD:

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

PROGRAM DESCRIPTION: Hypoglossal nerve stimulation (HNS) is effective therapy for patients with moderate-to-severe obstructive sleep apnea (OSA) who fail continuous positive airway pressure (CPAP). Given the prevalence of OSA and the increasing acceptance of HNS as a therapeutic option, the number of implanted patients is anticipated increase exponentially in future years. Although the positive effects of HNS are well-publicized, there is less focus on the limitations and potential complications of HNS. The panel presentation will focus on the limitations of HNS including suboptimal response, common side-effects, and expected complications. A case example of each will be presented followed by practical suggestions for improving care using evidence-based solutions and practice pearls. Suboptimal response will present management strategies for co-existing insomnia, and offer surgical strategies to improve the probability of success at the time of initial implantation, as well as the application of adjunctive devices and surgery to improve outcomes. Managing side-effects will offer selective strategies and helpful hints for painful stimulation, over titration, dental and soft tissue issues, frequent sleep arousals, and neck and chest scarring. Complications will focus on the recognition and management of wound infections, device extrusions, and the surgical approach to explants and revisions. Time will be allocated for audience questions of the panel. The goals of the presentation is the empower the comprehensive otolaryngologist with the techniques and tools to manage.

Learning Objectives:

Explain risk factors and reasons for suboptimal outcomes of HNS therapy.
Analyze suboptimal outcomes of HNS and apply strategies to improve patient response.
Recognize and apply strategies to mitigate common side-effects and complications of HNS therapy.

Moderator(s)

Marion B. Gillespie, MD

Professor and Chair
University of Tennessee Health Science Center
Memphis, TN, United States

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

Panelist(s)

Maria V. Suurna, MD

Professor
University of Miami
Miami, FL, United States

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

Associate Professor
Thomas Jefferson University Hospital - Department of Otolaryngology
Philadelphia, Pennsylvania, United States

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

David T. Kent, MD

Assistant Professor, Department of Otolaryngology - Head and Neck Surgery
Vanderbilt University Medical Center
Nashville, TN, United States

Disclosure information not submitted.