Hypoglossal nerve stimulation long-term clinical outcomes: a systematic review and meta-analysis
Objective To perform a systematic review and meta-analysis for studies evaluating hypoglossal nerve stimulation (HNS) clinical outcomes in the treatment of moderate to severe obstructive sleep apnea (OSA). Methods Two authors conducted a literature search to identify prospective studies in PubMed/ME...
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| Veröffentlicht in: | Sleep & breathing 2020-06, Vol.24 (2), p.399-411 |
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| creator | Costantino, Andrea Rinaldi, Vittorio Moffa, Antonio Luccarelli, Vitaliana Bressi, Federica Cassano, Michele Casale, Manuele Baptista, Peter |
| description | Objective
To perform a systematic review and meta-analysis for studies evaluating hypoglossal nerve stimulation (HNS) clinical outcomes in the treatment of moderate to severe obstructive sleep apnea (OSA).
Methods
Two authors conducted a literature search to identify prospective studies in PubMed/MEDLINE, Google Scholar, and Cochrane Library databases. The last search was performed on November 17, 2018.
Results
A total of 350 patients (median age 54.3 (IQR 53–56.25) years, BMI 29.8 (IQR 28.8–31.6) kg/m
2
) from 12 studies were included. The procedure has obtained a surgical success rate of 72.4% (Inspire), 76.9% (ImThera), 55% (Apnex) at 12 months, and 75% (Inspire) at 60-month follow-up. At 12 months, the apnea-hypopnea index (AHI) mean differences was − 17.50 (Inspire; 95% CI: − 20.01 to − 14.98,
P
|
| doi_str_mv | 10.1007/s11325-019-01923-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2275261561</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2275261561</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-d5526ebde677a7283e32faf4f89434e7a4b8f8119c69d333f8d28185bfa6bdb53</originalsourceid><addsrcrecordid>eNp9kE1r3DAQhkVp6CZp_0APRdBLL0o0kiXLvZWlyQYCuSRnRbbHi4NsbSU7Yf99tB9NoYccxAjmmXeGh5CvwC-A8_IyAUihGIdq94Rk4gM5BSUEg5JXH_d_zioFYkHOUnriHApTwSeykFCAAS1OyeNquwlrH1Jyno4Yn5GmqR9m76Y-jNSHcc0mjANtfD_2TYbCPDVhwPSTOpq2acIhow2N-NzjC3VjSwecHHOj89vUp8_kpHM-4ZdjPScPV7_vlyt2e3d9s_x1yxpZqom1SgmNdYu6LF0pjEQpOtcVnakKWWDpitp0BqBqdNVKKTvTCgNG1Z3TdVsreU5-HHI3MfyZMU126FOD3rsRw5ysEGXeAEpDRr__hz6FOeZ795TUXCstMiUOVBOznYid3cR-cHFrgdudf3vwb7N7u_dvd0PfjtFzPWD7NvJXeAbkAUi5Na4x_tv9TuwrEMCRMA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2273606562</pqid></control><display><type>article</type><title>Hypoglossal nerve stimulation long-term clinical outcomes: a systematic review and meta-analysis</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Costantino, Andrea ; Rinaldi, Vittorio ; Moffa, Antonio ; Luccarelli, Vitaliana ; Bressi, Federica ; Cassano, Michele ; Casale, Manuele ; Baptista, Peter</creator><creatorcontrib>Costantino, Andrea ; Rinaldi, Vittorio ; Moffa, Antonio ; Luccarelli, Vitaliana ; Bressi, Federica ; Cassano, Michele ; Casale, Manuele ; Baptista, Peter</creatorcontrib><description>Objective
To perform a systematic review and meta-analysis for studies evaluating hypoglossal nerve stimulation (HNS) clinical outcomes in the treatment of moderate to severe obstructive sleep apnea (OSA).
Methods
Two authors conducted a literature search to identify prospective studies in PubMed/MEDLINE, Google Scholar, and Cochrane Library databases. The last search was performed on November 17, 2018.
Results
A total of 350 patients (median age 54.3 (IQR 53–56.25) years, BMI 29.8 (IQR 28.8–31.6) kg/m
2
) from 12 studies were included. The procedure has obtained a surgical success rate of 72.4% (Inspire), 76.9% (ImThera), 55% (Apnex) at 12 months, and 75% (Inspire) at 60-month follow-up. At 12 months, the apnea-hypopnea index (AHI) mean differences was − 17.50 (Inspire; 95% CI: − 20.01 to − 14.98,
P
< 0.001), − 24.20 (ImThera; 95% CI: − 37.39 to 11.01,
P
< 0.001), and − 20.10 (Apnex; 95% CI: − 29.62 to − 10.58,
P
< 0.001). The AHI mean reduction after 5 years was − 18.00 (Inspire, − 22.38 to − 13.62,
P
< 0.001). The Epworth sleepiness scale (ESS) mean reduction was − 5.27 (Inspire), − 2.90 (ImThera), and − 4.20 (Apnex) at 12 months and − 4.40 (Inspire) at 60 months, respectively. Only 6% of patients reported serious device-related adverse events after 1- and 5-year follow-up.
Conclusion
HNS has obtained a high surgical success rate with reasonable long-term complication rate related to the device implanted. The procedure represents an effective and safe surgical treatment for moderate-severe OSA in selected adult patients who had difficulty accepting or adhering to CPAP treatment.</description><identifier>ISSN: 1520-9512</identifier><identifier>EISSN: 1522-1709</identifier><identifier>DOI: 10.1007/s11325-019-01923-2</identifier><identifier>PMID: 31418162</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Apnea ; Clinical outcomes ; Dentistry ; Electric Stimulation Therapy ; Humans ; Hypoglossal Nerve ; Internal Medicine ; Medicine ; Medicine & Public Health ; Meta-analysis ; Neurology ; Otorhinolaryngology ; Patients ; Pediatrics ; Pneumology/Respiratory System ; Prospective Studies ; Sleep ; Sleep and wakefulness ; Sleep Apnea, Obstructive - therapy ; Sleep Breathing Physiology and Disorders • Review ; Sleep disorders ; Systematic review ; Treatment Outcome</subject><ispartof>Sleep & breathing, 2020-06, Vol.24 (2), p.399-411</ispartof><rights>Springer Nature Switzerland AG 2019</rights><rights>Springer Nature Switzerland AG 2019.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-d5526ebde677a7283e32faf4f89434e7a4b8f8119c69d333f8d28185bfa6bdb53</citedby><cites>FETCH-LOGICAL-c375t-d5526ebde677a7283e32faf4f89434e7a4b8f8119c69d333f8d28185bfa6bdb53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11325-019-01923-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11325-019-01923-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31418162$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Costantino, Andrea</creatorcontrib><creatorcontrib>Rinaldi, Vittorio</creatorcontrib><creatorcontrib>Moffa, Antonio</creatorcontrib><creatorcontrib>Luccarelli, Vitaliana</creatorcontrib><creatorcontrib>Bressi, Federica</creatorcontrib><creatorcontrib>Cassano, Michele</creatorcontrib><creatorcontrib>Casale, Manuele</creatorcontrib><creatorcontrib>Baptista, Peter</creatorcontrib><title>Hypoglossal nerve stimulation long-term clinical outcomes: a systematic review and meta-analysis</title><title>Sleep & breathing</title><addtitle>Sleep Breath</addtitle><addtitle>Sleep Breath</addtitle><description>Objective
To perform a systematic review and meta-analysis for studies evaluating hypoglossal nerve stimulation (HNS) clinical outcomes in the treatment of moderate to severe obstructive sleep apnea (OSA).
Methods
Two authors conducted a literature search to identify prospective studies in PubMed/MEDLINE, Google Scholar, and Cochrane Library databases. The last search was performed on November 17, 2018.
Results
A total of 350 patients (median age 54.3 (IQR 53–56.25) years, BMI 29.8 (IQR 28.8–31.6) kg/m
2
) from 12 studies were included. The procedure has obtained a surgical success rate of 72.4% (Inspire), 76.9% (ImThera), 55% (Apnex) at 12 months, and 75% (Inspire) at 60-month follow-up. At 12 months, the apnea-hypopnea index (AHI) mean differences was − 17.50 (Inspire; 95% CI: − 20.01 to − 14.98,
P
< 0.001), − 24.20 (ImThera; 95% CI: − 37.39 to 11.01,
P
< 0.001), and − 20.10 (Apnex; 95% CI: − 29.62 to − 10.58,
P
< 0.001). The AHI mean reduction after 5 years was − 18.00 (Inspire, − 22.38 to − 13.62,
P
< 0.001). The Epworth sleepiness scale (ESS) mean reduction was − 5.27 (Inspire), − 2.90 (ImThera), and − 4.20 (Apnex) at 12 months and − 4.40 (Inspire) at 60 months, respectively. Only 6% of patients reported serious device-related adverse events after 1- and 5-year follow-up.
Conclusion
HNS has obtained a high surgical success rate with reasonable long-term complication rate related to the device implanted. The procedure represents an effective and safe surgical treatment for moderate-severe OSA in selected adult patients who had difficulty accepting or adhering to CPAP treatment.</description><subject>Apnea</subject><subject>Clinical outcomes</subject><subject>Dentistry</subject><subject>Electric Stimulation Therapy</subject><subject>Humans</subject><subject>Hypoglossal Nerve</subject><subject>Internal Medicine</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Neurology</subject><subject>Otorhinolaryngology</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Pneumology/Respiratory System</subject><subject>Prospective Studies</subject><subject>Sleep</subject><subject>Sleep and wakefulness</subject><subject>Sleep Apnea, Obstructive - therapy</subject><subject>Sleep Breathing Physiology and Disorders • Review</subject><subject>Sleep disorders</subject><subject>Systematic review</subject><subject>Treatment Outcome</subject><issn>1520-9512</issn><issn>1522-1709</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kE1r3DAQhkVp6CZp_0APRdBLL0o0kiXLvZWlyQYCuSRnRbbHi4NsbSU7Yf99tB9NoYccxAjmmXeGh5CvwC-A8_IyAUihGIdq94Rk4gM5BSUEg5JXH_d_zioFYkHOUnriHApTwSeykFCAAS1OyeNquwlrH1Jyno4Yn5GmqR9m76Y-jNSHcc0mjANtfD_2TYbCPDVhwPSTOpq2acIhow2N-NzjC3VjSwecHHOj89vUp8_kpHM-4ZdjPScPV7_vlyt2e3d9s_x1yxpZqom1SgmNdYu6LF0pjEQpOtcVnakKWWDpitp0BqBqdNVKKTvTCgNG1Z3TdVsreU5-HHI3MfyZMU126FOD3rsRw5ysEGXeAEpDRr__hz6FOeZ795TUXCstMiUOVBOznYid3cR-cHFrgdudf3vwb7N7u_dvd0PfjtFzPWD7NvJXeAbkAUi5Na4x_tv9TuwrEMCRMA</recordid><startdate>20200601</startdate><enddate>20200601</enddate><creator>Costantino, Andrea</creator><creator>Rinaldi, Vittorio</creator><creator>Moffa, Antonio</creator><creator>Luccarelli, Vitaliana</creator><creator>Bressi, Federica</creator><creator>Cassano, Michele</creator><creator>Casale, Manuele</creator><creator>Baptista, Peter</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7T5</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>88J</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2R</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20200601</creationdate><title>Hypoglossal nerve stimulation long-term clinical outcomes: a systematic review and meta-analysis</title><author>Costantino, Andrea ; Rinaldi, Vittorio ; Moffa, Antonio ; Luccarelli, Vitaliana ; Bressi, Federica ; Cassano, Michele ; Casale, Manuele ; Baptista, Peter</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-d5526ebde677a7283e32faf4f89434e7a4b8f8119c69d333f8d28185bfa6bdb53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Apnea</topic><topic>Clinical outcomes</topic><topic>Dentistry</topic><topic>Electric Stimulation Therapy</topic><topic>Humans</topic><topic>Hypoglossal Nerve</topic><topic>Internal Medicine</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Neurology</topic><topic>Otorhinolaryngology</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Pneumology/Respiratory System</topic><topic>Prospective Studies</topic><topic>Sleep</topic><topic>Sleep and wakefulness</topic><topic>Sleep Apnea, Obstructive - therapy</topic><topic>Sleep Breathing Physiology and Disorders • Review</topic><topic>Sleep disorders</topic><topic>Systematic review</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Costantino, Andrea</creatorcontrib><creatorcontrib>Rinaldi, Vittorio</creatorcontrib><creatorcontrib>Moffa, Antonio</creatorcontrib><creatorcontrib>Luccarelli, Vitaliana</creatorcontrib><creatorcontrib>Bressi, Federica</creatorcontrib><creatorcontrib>Cassano, Michele</creatorcontrib><creatorcontrib>Casale, Manuele</creatorcontrib><creatorcontrib>Baptista, Peter</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Social Science Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Social Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Sleep & breathing</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Costantino, Andrea</au><au>Rinaldi, Vittorio</au><au>Moffa, Antonio</au><au>Luccarelli, Vitaliana</au><au>Bressi, Federica</au><au>Cassano, Michele</au><au>Casale, Manuele</au><au>Baptista, Peter</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hypoglossal nerve stimulation long-term clinical outcomes: a systematic review and meta-analysis</atitle><jtitle>Sleep & breathing</jtitle><stitle>Sleep Breath</stitle><addtitle>Sleep Breath</addtitle><date>2020-06-01</date><risdate>2020</risdate><volume>24</volume><issue>2</issue><spage>399</spage><epage>411</epage><pages>399-411</pages><issn>1520-9512</issn><eissn>1522-1709</eissn><abstract>Objective
To perform a systematic review and meta-analysis for studies evaluating hypoglossal nerve stimulation (HNS) clinical outcomes in the treatment of moderate to severe obstructive sleep apnea (OSA).
Methods
Two authors conducted a literature search to identify prospective studies in PubMed/MEDLINE, Google Scholar, and Cochrane Library databases. The last search was performed on November 17, 2018.
Results
A total of 350 patients (median age 54.3 (IQR 53–56.25) years, BMI 29.8 (IQR 28.8–31.6) kg/m
2
) from 12 studies were included. The procedure has obtained a surgical success rate of 72.4% (Inspire), 76.9% (ImThera), 55% (Apnex) at 12 months, and 75% (Inspire) at 60-month follow-up. At 12 months, the apnea-hypopnea index (AHI) mean differences was − 17.50 (Inspire; 95% CI: − 20.01 to − 14.98,
P
< 0.001), − 24.20 (ImThera; 95% CI: − 37.39 to 11.01,
P
< 0.001), and − 20.10 (Apnex; 95% CI: − 29.62 to − 10.58,
P
< 0.001). The AHI mean reduction after 5 years was − 18.00 (Inspire, − 22.38 to − 13.62,
P
< 0.001). The Epworth sleepiness scale (ESS) mean reduction was − 5.27 (Inspire), − 2.90 (ImThera), and − 4.20 (Apnex) at 12 months and − 4.40 (Inspire) at 60 months, respectively. Only 6% of patients reported serious device-related adverse events after 1- and 5-year follow-up.
Conclusion
HNS has obtained a high surgical success rate with reasonable long-term complication rate related to the device implanted. The procedure represents an effective and safe surgical treatment for moderate-severe OSA in selected adult patients who had difficulty accepting or adhering to CPAP treatment.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>31418162</pmid><doi>10.1007/s11325-019-01923-2</doi><tpages>13</tpages></addata></record> |
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| subjects | Apnea Clinical outcomes Dentistry Electric Stimulation Therapy Humans Hypoglossal Nerve Internal Medicine Medicine Medicine & Public Health Meta-analysis Neurology Otorhinolaryngology Patients Pediatrics Pneumology/Respiratory System Prospective Studies Sleep Sleep and wakefulness Sleep Apnea, Obstructive - therapy Sleep Breathing Physiology and Disorders • Review Sleep disorders Systematic review Treatment Outcome |
| title | Hypoglossal nerve stimulation long-term clinical outcomes: a systematic review and meta-analysis |
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