Evaluation of In-Office Volitional Snore as a Screening Tool for Candidacy for Hypoglossal Nerve Stimulation. (March 2022)

• Record Type: Journal Article
• Authors: Yalamanchi, Pratyusha; Mott, Nicole; Ali, Syed Ahmed; Peddireddy, Nithin S.; Kovatch, Kevin J.; Stanley, Jeffrey J.; Hoff, Paul T.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 166:Number 3(2022)
• Page Start: 595
• Page End: 597
• Publication Date: 2022-03
• Subjects: upper airway stimulation -- obstructive sleep apnea -- sleep-disordered breathing -- sleep surgery -- drug-induced sleep endoscopy; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/01945998211023733
• Languages: English
• ISSNs: 0194-5998

Abstract

Candidacy evaluation for hypoglossal nerve stimulation (HGNS) is resource intensive. This proof-of-concept study investigates use of in-office volitional snore during flexible laryngoscopy as an efficient, cost-effective screening tool for HGNS evaluation. Adults with moderate to severe obstructive sleep apnea that failed continuous positive airway pressure treatment (n = 41) underwent evaluation for HGNS from 2018 to 2019. Volitional snore and drug-induced sleep endoscopy (DISE) data were collected and scored by VOTE classification (velum/palate, oropharynx, tongue base, epiglottis). A chi-square test of independence was performed that demonstrated a significant relationship between volitional snore and DISE (χ 2 = 4.39, P = .036) for velum collapse pattern. Sensitivity and specificity of volitional snore for detecting velum collapse pattern were 93.6% (95% CI, 75.6%-99.2%) and 40% (95% CI, 12.2%-73.8%), respectively, illustrating its utility in screening for HGNS. Patients who demonstrate anterior-posterior velum collapse on volitional snore may be excellent candidates for confirmatory DISE at the time of HGNS implantation.