Hackensack Meridian School of Medicine, Nutley, NJ, USA; Department of Otolaryngology - Head and Neck Surgery, Hackensack Meridian Health, Hackensack, NJ, USA.
Department of Otolaryngology - Head and Neck Surgery, Hackensack Meridian Health, Hackensack, NJ, USA; Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA.
Am J Otolaryngol. 2024 Sep-Oct;45(5):104391. doi: 10.1016/j.amjoto.2024.104391. Epub 2024 Jul 19.
Upper airway stimulation effectively treats patients with obstructive sleep apnea, especially among those with low long-term compliance with continuous positive airway pressure. Traditional methods to implant the hypoglossal nerve stimulator involve retraction of the digastric tendon to identify the nerve and improve exposure for stimulator implantation. Transient submental pain and discomfort are known side effects of the procedure. Placement without retraction provides an alternative approach to minimize postoperative pain. This study compares post-operative pain outcomes of patients in whom the digastric tendon was and was not retracted.
Retrospective chart review of patients who received the hypoglossal nerve stimulation implant at a single institution between 2017 and 2021. A combination of descriptive and qualitative data, including age, gender, comorbidities, and postoperative symptoms are analyzed to characterize patient outcomes resulting from this intraoperative technique. The categorical and continuous variables were analyzed using chi-squared tests and independent t-tests, respectively.
Patients report overall satisfaction after implantation and titration. A total of 108 patients underwent HGNS implantation between September 2017 and January 2021 using the aforementioned techniques. 1.69 % of patients experienced postoperative submental pain as compared to 18.37 % prior to the change in technique (p < 0.01).
Avoidance of digastric tendon retraction in the implantation of the stimulating lead is a safe and effective technique that reduces postoperative pain and discomfort. Our institution has demonstrated an alternative technique for hypoglossal stimulator implantation which improves perioperative outcomes.
Upper airway stimulation is an effective treatment for obstructive sleep apnea. During surgery, the digastric tendon is often moved to identify the nerve and improve access. This study shows that avoiding digastric tendon movement safely reduces postoperative pain and discomfort.
III.
上气道刺激有效地治疗阻塞性睡眠呼吸暂停患者，尤其是那些对持续气道正压通气治疗长期依从性低的患者。植入舌下神经刺激器的传统方法涉及牵引二腹肌肌腱以识别神经并改善刺激器植入的暴露度。已知该手术的术后短期颏下疼痛和不适是副作用。不牵引的放置提供了一种替代方法，可以最大程度地减少术后疼痛。本研究比较了牵引和不牵引二腹肌肌腱的患者术后疼痛结果。
对 2017 年至 2021 年期间在一家机构接受舌下神经刺激器植入的患者进行回顾性图表审查。采用描述性和定性数据的组合，包括年龄、性别、合并症和术后症状，对这种术中技术产生的患者结果进行分析。使用卡方检验和独立 t 检验分别分析分类变量和连续变量。
患者在植入和滴定后报告总体满意度。共有 108 名患者在 2017 年 9 月至 2021 年 1 月期间使用上述技术接受了 HGNS 植入。与技术变更前相比，术后颏下疼痛的患者比例为 1.69%，而技术变更前为 18.37%（p < 0.01）。
在刺激导联植入过程中避免牵引二腹肌肌腱是一种安全有效的技术，可以减少术后疼痛和不适。我们的机构已经证明了一种替代的舌下神经刺激器植入技术，可改善围手术期结果。
上气道刺激是治疗阻塞性睡眠呼吸暂停的有效方法。在手术中，通常会移动二腹肌肌腱以识别神经并改善进入。本研究表明，避免二腹肌肌腱运动可以安全地减轻术后疼痛和不适。
III 级。
