Abstract：
OBJECTIVE: Upper airway stimulation effectively treats patients with obstructive sleep apnea, especially among those with low long-term compliance with continuous positive airway pressure. Traditional methods to implant the hypoglossal nerve stimulator involve retraction of the digastric tendon to identify the nerve and improve exposure for stimulator implantation. Transient submental pain and discomfort are known side effects of the procedure. Placement without retraction provides an alternative approach to minimize postoperative pain. This study compares post-operative pain outcomes of patients in whom the digastric tendon was and was not retracted.
METHODS: Retrospective chart review of patients who received the hypoglossal nerve stimulation implant at a single institution between 2017 and 2021. A combination of descriptive and qualitative data, including age, gender, comorbidities, and postoperative symptoms are analyzed to characterize patient outcomes resulting from this intraoperative technique. The categorical and continuous variables were analyzed using chi-squared tests and independent t-tests, respectively.
RESULTS: Patients report overall satisfaction after implantation and titration. A total of 108 patients underwent HGNS implantation between September 2017 and January 2021 using the aforementioned techniques. 1.69 % of patients experienced postoperative submental pain as compared to 18.37 % prior to the change in technique (p < 0.01).
CONCLUSIONS: Avoidance of digastric tendon retraction in the implantation of the stimulating lead is a safe and effective technique that reduces postoperative pain and discomfort. Our institution has demonstrated an alternative technique for hypoglossal stimulator implantation which improves perioperative outcomes.
BACKGROUND: Upper airway stimulation is an effective treatment for obstructive sleep apnea. During surgery, the digastric tendon is often moved to identify the nerve and improve access. This study shows that avoiding digastric tendon movement safely reduces postoperative pain and discomfort.
METHODS: III.
METHODS: Retrospective chart review of patients who received the hypoglossal nerve stimulation implant at a single institution between 2017 and 2021. A combination of descriptive and qualitative data, including age, gender, comorbidities, and postoperative symptoms are analyzed to characterize patient outcomes resulting from this intraoperative technique. The categorical and continuous variables were analyzed using chi-squared tests and independent t-tests, respectively.
RESULTS: Patients report overall satisfaction after implantation and titration. A total of 108 patients underwent HGNS implantation between September 2017 and January 2021 using the aforementioned techniques. 1.69 % of patients experienced postoperative submental pain as compared to 18.37 % prior to the change in technique (p < 0.01).
CONCLUSIONS: Avoidance of digastric tendon retraction in the implantation of the stimulating lead is a safe and effective technique that reduces postoperative pain and discomfort. Our institution has demonstrated an alternative technique for hypoglossal stimulator implantation which improves perioperative outcomes.
BACKGROUND: Upper airway stimulation is an effective treatment for obstructive sleep apnea. During surgery, the digastric tendon is often moved to identify the nerve and improve access. This study shows that avoiding digastric tendon movement safely reduces postoperative pain and discomfort.
METHODS: III.
摘要：
目的：上呼吸道刺激有效治疗阻塞性睡眠呼吸暂停患者，尤其是那些长期依从性低的持续气道正压通气患者。植入舌下神经刺激器的传统方法涉及回缩腹腱以识别神经并改善刺激器植入的暴露。短暂的下颌下疼痛和不适是该手术的已知副作用。无回缩的放置提供了一种最小化术后疼痛的替代方法。这项研究比较了患者的术后疼痛结果，其中腹肌肌腱是和没有缩回。
方法：回顾性图表回顾了2017年至2021年在单一机构接受舌下神经刺激植入物的患者。描述性和定性数据的结合，包括年龄,性别,合并症,和术后症状进行了分析，以表征由这种术中技术导致的患者结局。使用卡方检验和独立t检验对分类变量和连续变量进行分析，分别。
结果：患者报告植入和滴定后的总体满意度。在2017年9月至2021年1月期间，共有108名患者使用上述技术进行了HGNS植入。1.69％的患者经历了术后精神下疼痛，而在技术改变之前为18.37％（p<0.01）。
结论：在植入刺激导线时避免腹肌肌腱回缩是一种安全有效的技术，可减少术后疼痛和不适。我们的机构已经证明了一种用于舌下神经刺激器植入的替代技术，可以改善围手术期的预后。
背景：上呼吸道刺激是阻塞性睡眠呼吸暂停的有效治疗方法。手术期间,经常移动腹肌肌腱以识别神经并改善通路。这项研究表明，避免腹肌肌腱运动可以安全地减少术后疼痛和不适。
方法：III.
方法：回顾性图表回顾了2017年至2021年在单一机构接受舌下神经刺激植入物的患者。描述性和定性数据的结合，包括年龄,性别,合并症,和术后症状进行了分析，以表征由这种术中技术导致的患者结局。使用卡方检验和独立t检验对分类变量和连续变量进行分析，分别。
结果：患者报告植入和滴定后的总体满意度。在2017年9月至2021年1月期间，共有108名患者使用上述技术进行了HGNS植入。1.69％的患者经历了术后精神下疼痛，而在技术改变之前为18.37％（p<0.01）。
结论：在植入刺激导线时避免腹肌肌腱回缩是一种安全有效的技术，可减少术后疼痛和不适。我们的机构已经证明了一种用于舌下神经刺激器植入的替代技术，可以改善围手术期的预后。
背景：上呼吸道刺激是阻塞性睡眠呼吸暂停的有效治疗方法。手术期间,经常移动腹肌肌腱以识别神经并改善通路。这项研究表明，避免腹肌肌腱运动可以安全地减少术后疼痛和不适。
方法：III.
