title: Hypoglossal nerve stimulation rescue surgery after multiple multilevel procedures for obstructive sleep apnea.
abstract: Hypoglossal nerve stimulation (HNS) is a new procedure offered for the treatment of moderate-to-severe obstructive sleep apnea (OSA) that has been shown to decrease the severity and symptoms of OSA in select patients. We report on a case of a patient with persistent symptoms and findings of OSA despite a history of multiple multilevel procedures, including an uvulopalatopharyngoplasty (UPPP) with revision, a genioglossus advancement, and a maxillomandibular advancement. The patient then underwent HNS with significant improvement of his symptoms and severity. The success of this patient's HNS surgery demonstrates that we need to examine where HNS fits into the approach to surgery for OSA. There could be benefit to considering cranial nerve stimulation earlier than conventional approaches for select patients.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University Hospitals Case Medical Center, Cleveland, OH, USA. Electronic address: mps93@case.edu.
authors.forename: Madeleine
authors.initials: M
authors.lastname: Strohl
authors.affiliation: Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA.
authors.forename: Kingman
authors.initials: K
authors.lastname: Strohl
authors.affiliation: Department of Orthodontics, Case Western Reserve University School of Dental Medicine, Cleveland, OH, USA.
authors.forename: J Martin
authors.initials: JM
authors.lastname: Palomo
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University Hospitals Case Medical Center, Cleveland, OH, USA.
authors.forename: Diana
authors.initials: D
authors.lastname: Ponsky
mesh_terms: D004599:Electric Stimulation Therapy; D006801:Humans; D007002:Hypoglossal Nerve; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures; D016879:Salvage Therapy; D020181:Sleep Apnea, Obstructive / Q000601:surgery*