Other criteria include: age above 22 years old, AHI between 15 and 65 on a recent sleep study, no more than 25 percent central apneas (including mixed), and a BMI of 35 or less. Patient profileĬandidates for hypoglossal nerve stimulation are those patients who have failed or are not candidates for CPAP or a dental device. Lack of sustainable outcomes has long been a concern with UPPP. This paper showed that the results have been sustainable. The STAR trial patients have been followed closely and the five-year follow–up was recently published. In patients who were matched for AHI, age and body mass index (BMI), hypoglossal nerve implantation was far superior to UPPP.įDA approval of the Inspire implant was based on the STAR trial published in The New England Journal of Medicine. We published a paper in 2018 comparing our UPPP results with our implant results. This reflects consistent improvement in the patients’ OSA after implantation. In 2017 alone, the preoperative apnea-hypopnea index (AHI) dropped from an average of 46 down to 4.6 in 27 patients. We have been tracking the outcomes of our hypoglossal nerve stimulation program since its inception four years ago. Likewise, the discussions with patients about which surgical options are available to them and which have the best outcomes have changed considerably. Since the onset of our implant program at Cleveland Clinic, the results of surgical obstructive sleep apnea treatment have improved significantly. There have been variations in technique over the years, but the vast majority of surgical therapy in the United States has been soft tissue surgery to the tonsils and palate. Uvulopalatopharyngoplasty (UPPP) has been the mainstay of treatment for OSA. When considering first-line choices of surgical therapy for those patients who don’t tolerate continuous positive airway pressure (CPAP), the hypoglossal nerve stimulator has changed the conversation about surgical options. The traditional choices for therapy of obstructive sleep apnea (OSA) were expanded in 2014 with the FDA approval of the Inspire® hypoglossal nerve stimulator implant. We do not endorse non-Cleveland Clinic products or services Policy Advertising on our site helps support our mission. Cleveland Clinic is a non-profit academic medical center.
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