Oral and Maxillofacial Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
ORL J Otorhinolaryngol Relat Spec. 2023;85(5):248-252. doi: 10.1159/000529011. Epub 2023 Feb 16.
Upper airway stimulation via the hypoglossal nerve stimulator (HGNS) implant is a surgical method for treating obstructive sleep apnea. However, patients may need the implant removed for a variety of reasons. The purpose of this case series is to assess surgical experiences with HGNS explantation at our institution. We report on surgical approach, overall operative times, operative and postoperative complications, and discuss relevant patient-specific surgical findings when removing the HGNS.
We performed a retrospective case series of all patients that underwent HGNS implantation at a single tertiary medical center between January 9, 2021, and January 9, 2022. Subjects included adult patients who presented to the sleep surgery clinic of the senior author for surgical management of previously implanted HGNS. Patient clinical history was reviewed to determine the timing of the patient's implant, reasons for explant, and postoperative recovery course. Operative reports were reviewed to determine overall duration of surgery and any associated difficulties or deviations from the general approach.
Between January 9, 2021, and January 9, 2022, 5 patients had an explantation of their HGNS implant. Explantation occurred between 8 and 63 months of their original implant surgery. The average operative time from incisional start time to close was 162 min for all cases with a range of 96-345 min. No significant complications were reported including pneumothorax and nerve palsy.
This reported case series outlines the general steps for Inspire HGNS explantation as well as details the experiences in a case series of 5 subjects explanted over the year at a single institution. The results from the cases suggest that the explantation of the device can be performed efficiently and safely.
通过舌下神经刺激器（HGNS）植入物对上气道进行刺激是治疗阻塞性睡眠呼吸暂停的一种手术方法。然而，由于各种原因，患者可能需要将植入物取出。本病例系列的目的是评估我们机构中 HGNS 摘除的手术经验。我们报告了手术方法、总手术时间、手术和术后并发症，并讨论了在移除 HGNS 时与患者具体情况相关的手术发现。
我们对 2021 年 1 月 9 日至 2022 年 1 月 9 日期间在一家三级医疗中心接受 HGNS 植入的所有患者进行了回顾性病例系列研究。研究对象包括因先前植入的 HGNS 而到高级作者的睡眠手术诊所接受手术治疗的成年患者。回顾患者的临床病史，以确定患者植入物的时间、取出原因和术后恢复过程。查阅手术报告，以确定手术的总持续时间以及任何与一般方法的差异或相关困难。
2021 年 1 月 9 日至 2022 年 1 月 9 日期间，有 5 名患者进行了 HGNS 植入物的取出。取出时间在最初植入手术的 8 至 63 个月之间。所有病例的平均手术时间（从切口开始到关闭的时间）为 162 分钟，范围为 96-345 分钟。没有报告任何重大并发症，包括气胸和神经麻痹。
本病例系列报告概述了 Inspire HGNS 摘除的一般步骤，并详细介绍了在一家机构中对 5 名患者进行的年度系列病例的经验。这些病例的结果表明，该设备的摘除可以高效、安全地进行。
