Comparing Upper Airway Stimulation to Expansion Sphincter Pharyngoplasty: A Single University Experience. (June 2018)

• Record Type: Journal Article
• Authors: Huntley, Colin; Chou, David W.; Doghramji, Karl; Boon, Maurits
• Is Part Of: Annals of otology, rhinology & laryngology. Volume 127:Number 6(2018)
• Page Start: 379
• Page End: 383
• Publication Date: 2018-06
• Subjects: obstructive sleep apnea -- sleep apnea -- sleep disordered breathing -- sleep medicine -- adult OSA surgical treatment; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0003489418771395
• Languages: English
• ISSNs: 0003-4894

Abstract

Introduction: Expansion sphincter pharyngoplasty (ESP) is a surgical option for patients with obstructive sleep apnea (OSA). Upper airway stimulation (UAS) is an alternative that has shown success in initial outcomes studies. We compare outcomes of a cohort of patients undergoing UAS to ESP. Methods: We compared demographic and polysomnographic data of the UAS to ESP cohorts. We also calculated the proportion of patients achieving surgical success. Results: The ESP cohort consisted of 33 patients. The mean preoperative Apnea-Hypopnea Index (AHI), O2 nadir, Epworth Sleepiness Scale (ESS), and BMI were 36.47 ± 20.01, 82.63 ± 5.37, 10.69 ± 4.42, and 29.6 ± 4.49, which improved to 13.47 ± 18.74, 84.84 ± 5.48, 7.00 ± 5.81, and 29.92 ± 4.59 postoperatively. There was a 63.64% success rate. The UAS cohort consisted of 75 patients. The mean preoperative AHI, O2 nadir, ESS, and BMI were 36.76 ± 20.72, 80.24 ± 8.43, 11.18 ± 4.16, and 29.50 ± 3.96, which improved to 7.25 ± 11.19, 88.71 ± 3.25, 5.36 ± 3.35, and 29.36 ± 3.68 postoperatively. The success rate was 86.67%. We found a significant difference in gender, age, preoperative AHI, postoperative AHI, postoperative O2 nadir, surgical success, and patients reaching an AHI less than 10 and 5. Conclusion: Upper airway stimulation is a new surgical option for select patients with OSA showing comparable or improved outcomes to a cohort of patients undergoing ESP.