0539 Outcomes Of Upper Airway Stimulation At A High Volume Academic Center

Abstract

Introduction: Upper airway stimulation (UAS) has emerged as a viable alternative therapy option for select patients with obstructive sleep apnea (OSA) who are unable to tolerate traditional positive pressure therapy. Prior data has shown benefit in both polysomnographic and quality of life variables. With this study, we reviewoutcomes of patients undergoingUAS at a single, high volume, academic center. Material(s) and Method(s): We performed a retrospective chart review of all patients undergoing UAS therapy at our institution. All patients had moderate to severe OSA, were unable to tolerate PAP therapy, and had amenable anatomic findings on drug induced sleep endoscopy. We recorded demographic data including age and gender. We used the Epworth sleepiness scale (ESS) to assess daytime sleepiness. We also evaluated preoperative polysomnogram (PSG) data including AHI and O2 desaturation nadir. Our primary outcome measure was postoperative AHI, O2 desaturation nadir, and ESS. The AHI was attained from the optimal treatment AHI during the postoperative titration PSG. We used a paired samples T test to compare pre and postoperative variables. Result(s): To date, we have performed 108 UAS implants at our institution. This cohort has consisted of 71 men and 37 women. The mean age and preoperative BMI were 61.65+/-11.96 years and 29.40+/-4.01 kg/m2 respectively. The mean preoperative AHI, O2 desaturation nadir, and ESS were 36.65+/-18.18, 79.75 +/-8.04, and 11.19+/-4.37 respectively. Eighty-seven of these patients have undergone postoperative titration PSG and were included in the analysis. The mean postoperative BMI was lower than the preoperative value; 28.29 +/-3.92 (p = 0.043). The mean postoperative AHI, O2 desaturation nadir, and ESS were 8.26+/-12.85, 89.01+/-3.42, and 5.67+/-3.35 respectively. These were all significantly different than the preoperative values (p < 0.001). Patients used therapy for a mean of 49.57+/-14.15 h per week. Defining success as a decline in postoperative AHI by 50%and to less than 20, 83.72% of patients reached surgical success. 85.06% reached an AHI less than 15 and 59.09% reached an AHI less than 5. Discussion(s): OSA impacts a significant proportion of our population and can influence quality of live and multiple comorbid cardiovascular disease states. The primary treatment modality for OSA is CPAP, but many patients are unable to tolerate therapy necessitating alternative options. UAS continues to show its ability to be well tolerated and successfully treat OSA in select patients mitigating both polysomnographic and quality of life measures.