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Title: |
Adjustable Tongue Advancement for Obstructive Sleep Apnea:
A Pilot Study |
| Authors: |
Evert Hamans, MD; An Boudewyns, MD, PhD; Boris A. Stuck, MD; Alexander Baisch, MD;
Marc Willemen; Johan Verbraecken, MD, PhD; Paul Van de Heyning, MD, PhD |
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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. (Ann Otol Rhinol Laryngol 2008;117:815-823.) |
| Keywords: |
hypopharynx, obstructive sleep apnea, sleep surgery, tongue base |
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