A Noninferiority Analysis of 3- vs 2-Incision Techniques for Hypoglossal Nerve Stimulator Implantation
| Autor: | Clemens Heiser, David T Kent, Eugene G. Chio, Jordan S. Weiner, Mark Weidenbecher, Maria V. Suurna |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Hypoglossal Nerve business.industry Polysomnography Lower chest Electric Stimulation Therapy Perioperative Sleep Medicine and Surgery hypoglossal nerve stimulation obstructive sleep apnea respiratory sensing lead 2-incision surgical technique medicine.disease Surgery ddc Obstructive sleep apnea Treatment Outcome Otorhinolaryngology Cohort Propensity score matching medicine Humans business Lead (electronics) Hypoglossal nerve Cohort study Retrospective Studies |
| Popis: | Objective The only hypoglossal nerve stimulation (HNS) device available for US clinical use is implanted through 3 incisions. A recently proposed 2-incision modification moved the respiratory sensing lead from the fifth to the second intercostal space to eliminate the third lower chest incision. This study compared perioperative data and therapeutic outcomes between the techniques. Study design Noninferiority cohort analysis of a retrospective and prospective registry study. Setting Tertiary care and community surgical centers. Methods Patients with obstructive sleep apnea underwent HNS implantation via a modified 2-incision technique (I2). A cohort previously implanted via the standard 3-incision technique (I3) were 1:1 propensity score matched for a noninferiority analysis of postoperative outcomes. Results There were 404 I3 patients and 223 I2 patients across 6 participating centers. Operative time decreased from 128.7 minutes (95% CI, 124.5-132.9) in I3 patients to 86.6 minutes (95% CI, 83.7-97.6) in I2 patients (P .05). Conclusion In a multicenter registry, a 2-incision implant technique for a commercially available HNS device had a statistically noninferior therapeutic efficacy profile when compared with the standard 3-incision approach. The 2-incision technique is safe and effective for HNS implantation. |
| Databáze: | OpenAIRE |
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