Palate surgery is the most common surgical treatment for obstructive sleep apnea, but palate surgery often improves but only rarely normalizes breathing patterns. One cause of limited results is the presence of hypopharyngeal airway obstruction (also called retrolingual or retroglossal obstruction) that may not be addressed with palate surgery. In an attempt to improve surgical outcomes, multiple procedures and therapies (including hypoglossal nerve stimulation) have been developed over the past 20-25 years and are often performed in combination with palate surgery.
No single hypopharyngeal procedure has emerged clearly as the “best” or most effective procedure. The evidence to justify the role of these treatments of hypopharyngeal obstruction is largely limited to case series studies; there is a wide variation in reported outcomes, ranging from a 35-62% chance of achieving a successful result. Because of the limitations of case series studies, it remains unclear how much of the differences in outcomes reported for various procedures represent true differences in effectiveness or whether the results are related to other factors such as patient selection. This session will present a framework that will enable surgeons to apply published studies to clinical practice, moving beyond the overly-simplistic summary findings to consider carefully patient factors that play an important role in outcomes. We review the literature on patient factors (age, gender, body mass index, drug-induced sleep endoscopy findings, apnea-hypopnea index, cephalometric measurements) that have been associated specifically with outcomes of hypopharyngeal procedures, including hypoglossal nerve stimulation, genioglossus advancement, tongue radiofrequency, midline glossectomy, tongue stabilization, and hyoid suspension.
- Provider:American Academy of Otolaryngology – Head & Neck Surgery Foundation
- Activity Link: https://academyu.entnet.org/diweb/catalog/item?id=10926723
- Start Date: 2022-10-12 05:00:00
- End Date: 2022-10-12 05:00:00
- Credit Details: AMA PRA Category 1 Credit™️: 1.0 hours
- MOC Credit Details: ABOHNS - 1.0 Point; Credit Type(s): Self-Assessment (ABOHNS)
- Commercial Support: No
- Activity Type: Enduring Material
- CME Finder Type: Online Learning
- Fee to Participate: Yes
- Measured Outcome: Community/Population Health, Learner Competence, Learner Knowledge, Learner Performance, Patient Health
- Provider Ship: Directly Provided
- Registration: Open to all
- Specialty: Sleep Medicine