title: A novel nasopharyngeal stent for the treatment of obstructive sleep apnea: a case series of nasopharyngeal stenting versus continuous positive airway pressure.
abstract: The objective of the study was to investigate the first-night treatment success of a nasopharyngeal stent compared to standard nCPAP-titration. This is a case series and a single-center study. Eight participants (n = 8) were selected with untreated obstructive sleep apnea with a prestudy AHI ≥ 10. A newly developed nasopharyngeal stent was tested individually versus standard nCPAP-titration. Cardiorespiratory polysomnography was performed on two consecutive nights (random order: stent, nCPAP). The AHI, the number of obstructive apneas and hypopneas, the mean oxygen saturation, and the minimum oxygen saturation were compared before and after using the nasopharyngeal stent or standard nCPAP. The AHI value before treatment (AHIpre) was 31.1 ± 12.0 (mean ± standard deviation). After inserting the AlaxoStent, the mean AHIstent was 19 ± 12.0 compared to mean AHInCPAP 8.2 ± 11.9 with standard nCPAP-titration. Both nasopharyngeal stenting and nCPAP-titration could reduce the mean number of obstructive apneas by >94 %. Compared to responder rates of classic surgical interventions like uvulopalatopharyngoplasty or multi-level surgery, the nasopharyngeal stent seems to give a comparable responder rate of 50 %. There were no complications associated with the use of the stent and it was well tolerated by all subjects. Nasopharyngeal stenting widens the range of non-invasive mechanical treatment and seems to be an effective mechanical therapeutic alternative to surgery in nCPAP non-compliant patients with OSA. Careful selection of the patient population is a prerequisite of treatment and therefore it should be reserved for individual cases only.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, Waldstrasse 1, 91054, Erlangen, Germany. maximilian.traxdorf@uk-erlangen.de.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Traxdorf
authors.affiliation: Private Practice for Otorhinolaryngology, Cham, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Hartl
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, Waldstrasse 1, 91054, Erlangen, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Angerer
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, Waldstrasse 1, 91054, Erlangen, Germany.
authors.forename: Christopher
authors.initials: C
authors.lastname: Bohr
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, Waldstrasse 1, 91054, Erlangen, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Grundtner
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, Waldstrasse 1, 91054, Erlangen, Germany.
authors.forename: Heinrich
authors.initials: H
authors.lastname: Iro
mesh_terms: D000328:Adult; D057186:Comparative Effectiveness Research; D045422:Continuous Positive Airway Pressure / Q000295:instrumentation / Q000379:methods / Q000523:psychology; D004867:Equipment Design; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D009305:Nasopharynx / Q000503:physiopathology; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data; D018579:Patient Selection; D017286:Polysomnography / Q000379:methods; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D015607:Stents; D016896:Treatment Outcome
keywords: Nasopharyngeal stent; Non-CPAP therapies; Obstructive sleep apnea; nCPAP incompliance