Document Detail


Adjustable tongue advancement for obstructive sleep apnea: a pilot study.
MedLine Citation:
PMID:  19102126     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Evert Hamans; An Boudewyns; Boris A Stuck; Alexander Baisch; Marc Willemen; Johan Verbraecken; Paul Van de Heyning
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Publication Detail:
Type:  Clinical Trial, Phase I; Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of otology, rhinology, and laryngology     Volume:  117     ISSN:  0003-4894     ISO Abbreviation:  Ann. Otol. Rhinol. Laryngol.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-12-23     Completed Date:  2009-01-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0407300     Medline TA:  Ann Otol Rhinol Laryngol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  815-23     Citation Subset:  AIM; IM    
Affiliation:
Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Antwerp, Antwerp, Belgium. evert.hamans@uza.be
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MeSH Terms
Descriptor/Qualifier:
Adult
Equipment Design
Follow-Up Studies
Humans
Male
Middle Aged
Oral Surgical Procedures / instrumentation*
Pilot Projects
Polysomnography
Prospective Studies
Sleep Apnea, Obstructive / physiopathology,  surgery*
Tongue / surgery*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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