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[Upper Airway Stimulation for obstructive sleep apnea-Can radiological position monitoring predict tongue motion one year after implantation? German version].
HNO 2019; 67(9):690-697HNO

Abstract

BACKGROUND

Tongue motion patterns (TMP) can influence the outcome of upper airway stimulation (UAS) in the treatment of obstructive sleep apnea (OSA). As a postoperative control the cuff position of the stimulation lead is monitored via X‑ray imaging. A multidimensional X‑ray assessment system was established and the association between these positional assessments and TMP was investigated 1 year after implantation.

MATERIAL AND METHODS

The study on TMP and the X‑ray assessments were carried out at a German ear nose and throat clinic as an implantation center. The TMPs were assessed under bipolar electrode configuration and were categorized according to the currently available literature as right-sided protrusion (RP), left-sided protrusion (LP), bilateral protrusion (BP) and mixed activation (MA). The X‑ray assessment was carried out in five dimensions: the position relative to the mandible and hyoid, cuff steepness in the lateral view of the neck, the cuff position based on the single electrode and the lead connection to the cuff in the anterior-posterior view. The analyses were performed by three raters with different medical backgrounds and knowledge regarding TMP.

RESULTS

In approximately 60% of the patients the apnea-hypopnea index was reduced to below 15/h, 1 year after implantation. The most common TMPs were RP and BP (82.9%). The interrater variability of the X‑ray assessment was good except for one category. Furthermore, no relevant associations were found apart from the correlation between a favorable TMP and the cuff position with respect to the lateral position of the stimulation cable.

CONCLUSION

Despite good interrater variability and convenient usage of the suggested X‑ray assessment system, this approach did not enable the identification of any associations, by which a TM and therefore a possible straightforward or complicated treatment pathway could be predicted. Attention should possibly be paid to a rotation of the cuff during implantation with a lateral position of the stimulation lead.

Authors+Show Affiliations

Klinik für Hals-Nasen- und Ohrenheilkunde, Universitätsklinikum Schleswig-Holstein, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland. armin.steffen@uksh.de.Klinik für Hals-Nasen- und Ohrenheilkunde, Universitätsklinikum Schleswig-Holstein, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.Institut für Medizinische Biometrie und Statistik, Universität zu Lübeck, Lübeck, Deutschland.Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Schleswig-Holstein, Universität zu Lübeck, Lübeck, Deutschland.Klinik für Hals-Nasen- und Ohrenheilkunde, Universitätsklinikum Schleswig-Holstein, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.Klinik für Hals-Nasen- und Ohrenheilkunde, Universitätsklinikum Schleswig-Holstein, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.

Pub Type(s)

English Abstract
Journal Article

Language

ger

PubMed ID

31414154

Citation

Steffen, A, et al. "[Upper Airway Stimulation for Obstructive Sleep apnea-Can Radiological Position Monitoring Predict Tongue Motion One Year After Implantation? German Version]." HNO, vol. 67, no. 9, 2019, pp. 690-697.
Steffen A, Wozny AS, König IR, et al. [Upper Airway Stimulation for obstructive sleep apnea-Can radiological position monitoring predict tongue motion one year after implantation? German version]. HNO. 2019;67(9):690-697.
Steffen, A., Wozny, A. S., König, I. R., Goltz, J. P., Wollenberg, B., & Hasselbacher, K. (2019). [Upper Airway Stimulation for obstructive sleep apnea-Can radiological position monitoring predict tongue motion one year after implantation? German version]. HNO, 67(9), pp. 690-697. doi:10.1007/s00106-019-0715-6.
Steffen A, et al. [Upper Airway Stimulation for Obstructive Sleep apnea-Can Radiological Position Monitoring Predict Tongue Motion One Year After Implantation? German Version]. HNO. 2019;67(9):690-697. PubMed PMID: 31414154.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Upper Airway Stimulation for obstructive sleep apnea-Can radiological position monitoring predict tongue motion one year after implantation? German version]. AU - Steffen,A, AU - Wozny,A S, AU - König,I R, AU - Goltz,J-P, AU - Wollenberg,B, AU - Hasselbacher,K, PY - 2019/8/16/pubmed PY - 2019/8/16/medline PY - 2019/8/16/entrez KW - Hypoglossus nerve stimulation KW - Interrater variability KW - PAP failure KW - Rating system KW - Tongue protrusion SP - 690 EP - 697 JF - HNO JO - HNO VL - 67 IS - 9 N2 - BACKGROUND: Tongue motion patterns (TMP) can influence the outcome of upper airway stimulation (UAS) in the treatment of obstructive sleep apnea (OSA). As a postoperative control the cuff position of the stimulation lead is monitored via X‑ray imaging. A multidimensional X‑ray assessment system was established and the association between these positional assessments and TMP was investigated 1 year after implantation. MATERIAL AND METHODS: The study on TMP and the X‑ray assessments were carried out at a German ear nose and throat clinic as an implantation center. The TMPs were assessed under bipolar electrode configuration and were categorized according to the currently available literature as right-sided protrusion (RP), left-sided protrusion (LP), bilateral protrusion (BP) and mixed activation (MA). The X‑ray assessment was carried out in five dimensions: the position relative to the mandible and hyoid, cuff steepness in the lateral view of the neck, the cuff position based on the single electrode and the lead connection to the cuff in the anterior-posterior view. The analyses were performed by three raters with different medical backgrounds and knowledge regarding TMP. RESULTS: In approximately 60% of the patients the apnea-hypopnea index was reduced to below 15/h, 1 year after implantation. The most common TMPs were RP and BP (82.9%). The interrater variability of the X‑ray assessment was good except for one category. Furthermore, no relevant associations were found apart from the correlation between a favorable TMP and the cuff position with respect to the lateral position of the stimulation cable. CONCLUSION: Despite good interrater variability and convenient usage of the suggested X‑ray assessment system, this approach did not enable the identification of any associations, by which a TM and therefore a possible straightforward or complicated treatment pathway could be predicted. Attention should possibly be paid to a rotation of the cuff during implantation with a lateral position of the stimulation lead. SN - 1433-0458 UR - https://www.unboundmedicine.com/medline/citation/31414154/[Upper_Airway_Stimulation_for_obstructive_sleep_apnea-Can_radiological_position_monitoring_predict_tongue_motion_one_year_after_implantation_German_version] L2 - https://dx.doi.org/10.1007/s00106-019-0715-6 DB - PRIME DP - Unbound Medicine ER -