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European Archives of Oto-Rhino-Laryngology

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26.06.2020 | Head and Neck

Safety and effectiveness in explantation and re-implantation of hypoglossal nerve stimulation devices

verfasst von: Philipp Arens, Thomas Penzel, Ingo Fietze, Alexander Blau, Bodo Weller, Heidi Olze, Steffen Dommerich

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 2/2021

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Abstract

Purpose

Since 2001, hypoglossal nerve stimulators have been implanted in patients with obstructive sleep apnea around the world, initially in trial situations but more recently also in regular care settings. Medium term data indicate effectiveness and tolerability of treatment. However, when assessing the safety of the procedure, the safe feasibility of explantation or reimplantation must also be considered.

Patients and methods

Nine patients with an implanted respiratory-driven hypoglossal nerve stimulator. We have evaluated the feasibility and safety of explantation or re-implantation with another stimulation system.

Results

In 2012, nine patients were implanted with a respiratory-driven hypoglossal nerve stimulator as part of the Apnex Medical Pivotal Study. The study was ended in 2013. For a variety of reasons, the system was explanted from all nine patients by the year 2019. Three of these patients were re-implanted with a different system with respiratory sensing during the same session (mean incision to closure time for explantation 88.2 ± 35.01 min., mean incision to closure time for re-implantation 221.75 ± 52.73 min.). Due to extensive scar tissue formation, all procedures were technically challenging. Complication rate was significantly higher when re-implantation was performed or attempted in the same surgical session (0 of 5 patients with explantation versus 3 of 4 patients with attempted re-implantation; p = 0.018). There was no significant difference between the AHI values before and after implantation in patients with re-implantation.

Conclusion

Explantation and re-implantation are technically challenging though possible procedures. The single-staged equilateral reimplantation of another hypoglossal nerve stimulation system can, but need not, be successful.

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Titel: Safety and effectiveness in explantation and re-implantation of hypoglossal nerve stimulation devices
verfasst von: Philipp Arens
Thomas Penzel
Ingo Fietze
Alexander Blau
Bodo Weller
Heidi Olze
Steffen Dommerich
Publikationsdatum: 26.06.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: European Archives of Oto-Rhino-Laryngology / Ausgabe 2/2021
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-020-06170-w

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Safety and effectiveness in explantation and re-implantation of hypoglossal nerve stimulation devices

Abstract

Purpose

Patients and methods

Results

Conclusion

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Intrakapsuläre Tonsillektomie gewinnt an Boden

Bilateraler Hörsturz hat eine schlechte Prognose

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Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Purpose

Patients and methods

Results

Conclusion

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