Evaluation of In‐Office Volitional Snore as a Screening Tool for Candidacy for Hypoglossal Nerve Stimulation. (29th June 2021)

• 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: 2021-06-29
• 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

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.