Adjustable Tongue Advancement for Obstructive Sleep Apnea: A Pilot Study

Objectives: Surgical treatment of obstructive sleep apnea (OSA) caused by hypopharyngeal collapse of the upper airway can be considered in patients who are intolerant to continuous positive airway pressure (CPAP). The present procedures addressing the hypopharynx are invasive and have substantial mo...

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Bibliographic Details
Published in:Annals of otology, rhinology & laryngology rhinology & laryngology, 2008-11, Vol.117 (11), p.815-823
Main Authors: Hamans, Evert, Boudewyns, An, Stuck, Boris A., Baisch, Alexander, Willemen, Marc, Verbraecken, Johan, Van de Heyning, Paul
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Equipment Design
Follow-Up Studies
Humans
Male
Medical sciences
Middle Aged
Oral Surgical Procedures - instrumentation
Otorhinolaryngology. Stomatology
Pilot Projects
Pneumology
Polysomnography
Prospective Studies
Respiratory system : syndromes and miscellaneous diseases
Sleep Apnea, Obstructive - physiopathology
Sleep Apnea, Obstructive - surgery
Tongue - surgery
Treatment Outcome
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Summary:Objectives: Surgical treatment of obstructive sleep apnea (OSA) caused by hypopharyngeal collapse of the upper airway can be considered in patients who are intolerant to continuous positive airway pressure (CPAP). The present procedures addressing the hypopharynx are invasive and have substantial morbidity and limited efficacy. Methods: Ten patients (mean age, 44 years) with moderate to severe OSA, ie, an apnea-hypopnea index (AHI) between 15 and 50, with CPAP intolerance were included in a prospective, nonrandomized, multicenter study to evaluate the feasibility, safety, and efficacy of a novel tongue advancement procedure. The procedure consists of the implantation of a tissue anchor in the tongue base and an adjustment spool at the mandible. Titration of this tissue anchor results in advancement of the tongue and a patent upper airway. Results: The mean AHI decreased from 22.8 at baseline to 11.8 at the 6-month follow-up (p = 0.007). The Epworth Sleepiness Scale score decreased from 11.4 at baseline to 7.7 at the 6-month follow-up (p = 0.094), and the snoring score decreased from 7.5 at baseline to 3.9 at the 6-month follow-up (p = 0.005). Four technical adverse events were noted, and 1 clinical adverse event occurred. Conclusions: Adjustable tongue advancement is a feasible and relatively safe way to reduce the AHI and snoring in selected patients with moderate to severe OSA and CPAP intolerance. Technical improvements and refinements to the procedure are ongoing.
ISSN:0003-4894
1943-572X
DOI:10.1177/000348940811701104