Scientific publications

Hypoglossal nerve stimulation long-term clinical outcomes: a systematic review and meta-analysis

Costantino A (1), Rinaldi V (1), Moffa A (2), Luccarelli V 1, Bressi F (3), Cassano M (4), Casale M (1), Baptista P (5).

(1) Unit of Otolaryngology, UOS ORL TI, Campus Bio-Medico University, Rome, Italy.
(2) Unit of Otolaryngology, University of Foggia, Foggia, Italy.
(3) Department of Physical and Rehabilitation Medicine, Campus Bio-Medico University, Rome, Italy.
(4) Unit of Otolaryngology, University of Foggia, Foggia, Italy.
(5) Unit of Otolaryngology, Clínica Universidad de Navarra, Pamplona, Spain.

Magazine: Sleep Breath

Date: Aug 15, 2019

Otorhinolaryngology Department [SP]

OBJECTIVE:

To perform a systematic review and meta-analysis for studies evaluating hypoglossal nerve stimulation (HNS) clinical outcomes in the treatment of moderate to severe obstructive sleep apnea (OSA).

METHODS:

Two authors conducted a literature search to identify prospective studies in PubMed/MEDLINE, Google Scholar, and Cochrane Library databases. The last search was performed on November 17, 2018.

RESULTS:

A total of 350 patients (median age 54.3 (IQR 53-56.25) years, BMI 29.8 (IQR 28.8-31.6) kg/m2) from 12 studies were included. The procedure has obtained a surgical success rate of 72.4% (Inspire), 76.9% (ImThera), 55% (Apnex) at 12 months, and 75% (Inspire) at 60-month follow-up. At 12 months, the apnea-hypopnea index (AHI) mean differences was - 17.50 (Inspire; 95% CI: - 20.01 to - 14.98, P < 0.001), - 24.20 (ImThera; 95% CI: - 37.39 to 11.01, P < 0.001), and - 20.10 (Apnex; 95% CI: - 29.62 to - 10.58, P < 0.001). The AHI mean reduction after 5 years was - 18.00 (Inspire, - 22.38 to - 13.62, P < 0.001). The Epworth sleepiness scale (ESS) mean reduction was - 5.27 (Inspire), - 2.90 (ImThera), and - 4.20 (Apnex) at 12 months and - 4.40 (Inspire) at 60 months, respectively. Only 6% of patients reported serious device-related adverse events after 1- and 5-year follow-up.

CONCLUSION:

HNS has obtained a high surgical success rate with reasonable long-term complication rate related to the device implanted. The procedure represents an effective and safe surgical treatment for moderate-severe OSA in selected adult patients who had difficulty accepting or adhering to CPAP treatment.

CITATION  Sleep Breath. 2019 Aug 15. doi: 10.1007/s11325-019-01923-2

you maybe interested

WHAT TECHNOLOGY
DO WE USE?

The Clínica is the greater private hospital with technological equipment of Spain, all in a single center.

Imagen de un PET, tecnología de vanguardia en la Clínica Universidad de Navarra

OUR
PROFESSIONALS

The professionals of the Clínica perform continuous research and training, always to the benefit of the patient.

Imagen profesionales de la Clínica Universidad de Navarra

WHY CHOOSE
THE CLINICA?

Learn why we are different from other healthcare centers. Quality, speed, comfort and results.

Imagen del edificio de la Clínica Universidad de Navarra