0581 OUTCOMES FOR A LARGE COHORT OF PATIENTS UNDERGOING UPPER AIRWAY STIMULATION THERAPY: THE JEFFERSON EXPERIENCE

• Published in: Sleep (New York, N.Y.) N.Y.), 2017-04, Vol.40 (suppl_1), p.A215-A216
• Main Authors: Doghramji, K, Huntley, C, Boon, M
• Format: Article
• Language: English
• Subjects: Airway management; Sleep apnea; Standard deviation; Surgical outcomes
• ISSN: 0161-8105; 1550-9109
• DOI: 10.1093/sleepj/zsx050.580

Abstract Introduction: Upper airway stimulation (UAS) is a novel technique of treating select patients with obstructive sleep apnea (OSA) unable to tolerate CPAP. Current outcome studies consist of the STAR clinical trial publications and small volume institutional outcomes. We present the largest single institution outcome study to date and hypothesize that we will confirm the STAR trial results in a clinical setting. Methods: We reviewed our database of patients undergoing UAS since the initiation of our program in 2014. We collected demographic data including age, gender, BMI, and Epworth sleepiness score (ESS) results. We also reviewed pre and postoperative polysomnography (PSG) data including AHI, and O2 nadir. Lastly we calculated rates of surgical success, and patients reaching a postoperative AHI less than 15, 10, and 5. Surgical success was defined as a drop in postoperative AHI of 50% and to a value less than 20. Lastly, we recorded surgical complications. Results: We have performed 66 UAS implantations. 50 of these patients have undergone a postoperative titration PSG. The cohort consists of 31 men and 19 women. The mean age was 61.1 years with a standard deviation of 11.6. The mean preoperative AHI, O2 nadir, and ESS scores were 34.4, 81.4, and 10.6 with a standard deviation of 21.2, 6.9 and 6.9 respectively. The mean postoperative AHI, O2 nadir, and ESS scores were 6.5, 88.5, and 6.2 with a standard deviation of 11.4, 3.5, and 3.4 respectively. The postoperative values were all significantly improved from preoperative. The success rate was 89.8%. The percent of patients reaching a postoperative AHI less than 15, 10, and 5 was 93.9%, 83.7%, and 65.3% respectively. Untoward outcomes included 1 temporary hypoglossal nerve paresis, no wound infections, no bleeding requiring return to the operating room, no hematoma formation, and 1 implant removal at the patient’s request. Conclusion: UAS is an innovative addition to the treatment repertoire for select patients with OSA unable to tolerate CPAP. Initial findings show it to be a successful method of controlling upper airway obstruction and apnea. Our outcome data are very similar to those obtained in STAR trial. Support (If Any): none.