title: Continuing the Original Stanford Sleep Surgery Protocol From Upper Airway Reconstruction to Upper Airway Stimulation: Our First Successful Case.
abstract: In 1993, a surgical protocol for dynamic upper airway reconstruction in patients with obstructive sleep apnea (OSA) was published, and it became commonly known as the Stanford phase 1 and 2 sleep surgery protocol. It served as a platform on which research and clinical studies have continued to perfect the surgical care of patients with OSA. However, relapse is inevitable in a chronic condition such as OSA, and a subset of previously cured surgical patients return with complaints of excessive daytime sleepiness. This report describes a patient who was successfully treated with phase 1 and 2 operations more than a decade previously. He returned at 65 years of age with relapse of moderate OSA, and after workup with polysomnography and drug-induced sleep endoscopy, he underwent upper airway stimulation of the hypoglossal nerve that resulted in a cure of OSA. This case shows why upper airway stimulation is an appropriate option for patients with OSA relapse, after previously successful maxillomandibular advancement.
authors.affiliation: Assistant Professor and Co-Director of Stanford Sleep Surgery Fellowship, Division of Sleep Surgery, Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA. Electronic address: ycliu@stanford.edu.
authors.forename: Stanley Yung
authors.initials: SY
authors.lastname: Liu
authors.affiliation: Clinical Professor of Stanford Sleep Surgery, Division of Sleep Surgery, Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA.
authors.forename: Robert Wayne
authors.initials: RW
authors.lastname: Riley
mesh_terms: D002985:Clinical Protocols; D004599:Electric Stimulation Therapy; D004724:Endoscopy; D006801:Humans; D008297:Male; D019186:Mandibular Advancement; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery; D010159:Palate / Q000601:surgery; D012008:Recurrence; D012074:Remission Induction; D012890:Sleep; D020181:Sleep Apnea, Obstructive / Q000601:surgery / Q000628:therapy*; D013524:Surgical Flaps