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Sleep Medicine

Surgeon's Role for Nonresponders to Hypoglossal Nerve Stimulation

Monday, October 2, 2023
5:00 PM - 6:00 PM East Coast USA Time
Location: 103A

    Moderator(s)

  • Eric James Kezirian, MD, MPH

    Professor, Head and Neck Surgery
    David Geffen School of Medicine at UCLA
    Santa Monica, CA, United States

    • Panelist(s)

  • Raj C. Dedhia, MD, MSCR

    Associate Professor of Otorhinolaryngology & Medicine
    Division of Sleep Surgery, Penn Otorhinolaryngology
    Philadelphia, PA, United States

  • Clemens Heiser, MD, PhD

    Professor and ENT, Head and Neck Surgeon
    Technical University of Munich
    Munich, Bayern, Germany

  • Maria V. Suurna, MD

    Professor
    University of Miami
    Miami, FL, United States

Disclosure(s):
Eric James Kezirian, MD, MPH: No relevant relationships to disclose.
Raj C. Dedhia, MD, MSCR: No relevant relationships to disclose.
Clemens Heiser, MD, PhD: No relevant relationships to disclose.
PROGRAM DESCRIPTION: Hypoglossal nerve stimulation is an important treatment option for obstructive sleep apnea, and its use is growing wordwide. Treatment success occurs in 60-70% of implanted patients, but this still leaves many patients classified as nonresponders. While sleep medicine providers often assume a primary role in the initial care of patients treated with hypoglossal nerve stimulation, surgeons can play a key role in evaluation and additional treatment for nonresponders.

This interactive session will utilize cases and the audience response system, discussing the underlying anatomic and non-anatomic mechanisms for nonresponse as the basis for guiding treatment. The session will combine existing research with expert opinion and experience to provide attendees with a framework for making treatment decisions. The session will specifically address the therapeutic role of changes in hypoglossal nerve stimulation system system settings, revision surgery related to the system, additional pharyngeal surgery, and other conservative options (including medications, positional therapy, weight loss, positive airway pressure therapy).

OUTCOME OBJECTIVE 1: Recognize the most common anatomic and non-anatomic mechanisms for nonresponse to hypoglossal nerve stimulation

OUTCOME OBJECTIVE 2: Understand the potential treatment options for nonresponse

OUTCOME OBJECTIVE 3: Implement a framework that incorporates identification of the mechanism of nonresponse and treatment options

BACKGROUND STATEMENT: There are growing numbers of patients who do not respond fully to hypoglossal nerve stimulation, with no clear framework for treating them. The available literature is important but has limitations, such that there is a real need for incorporating expert opinion and experiences on this topic.