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Hypoglossal nerve stimulation explantation in patients with obstructive sleep apnoea: a systematic review

Published online by Cambridge University Press:  25 October 2024

Zachary Chu ,
Chen Zhang ,
Enoch Kwok Open the ORCID record for Enoch Kwok [Opens in a new window] ,
Yaoyi Ng ,
Tony Tang ,
Song Tar Toh ,
Shaun Loh  and
John Loh Open the ORCID record for John Loh [Opens in a new window]
Zachary Chu
Affiliation:
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
Chen Zhang
Affiliation:
Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
Enoch Kwok
Affiliation:
Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
Yaoyi Ng
Affiliation:
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
Tony Tang
Affiliation:
Yale-NUS College, National University of Singapore, Singapore, Singapore
Song Tar Toh
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Singapore General Hospital, Singapore; Singhealth Duke-NUS Sleep Centre, Singapore, Singapore
Shaun Loh
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Singapore General Hospital, Singapore; Singhealth Duke-NUS Sleep Centre, Singapore, Singapore
John Loh*
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Changi General Hospital, Singapore, Singapore
*
Corresponding author: John Loh; Email: john.loh.m.r@singhealth.com.sg
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Abstract

Objective

Hypoglossal nerve stimulation has emerged as a promising therapeutic approach for obstructive sleep apnoea patients who are intolerant to continuous positive airway pressure therapy. This paper aimed to explore reasons for hypoglossal nerve stimulation device explantation and associated complications.

Methods

Following Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, a systematic search across Embase Ovid, PubMed, Scopus, and the Cochrane library yielded 14 articles that met the inclusion criteria. Exclusion criteria were (1) systematic reviews and meta-analyses, conference posters and editorials; (2) non-English studies; and (3) studies published before 2010.

Results

Of the 121 patients identified as having undergone hypoglossal nerve stimulation device explantation, 126 reasons were identified for the procedure. The primary reasons included device malfunction (19.8 per cent), infection (19.0 per cent) and device migration (18.3 per cent). Other reasons included discomfort (9.5 per cent), improper placement (6.3 per cent) and ineffective devices (6.3 per cent). Complications were infrequent (2.48 per cent).

Conclusion

Device malfunction, infection and device migration were prominent reasons for hypoglossal nerve stimulation device explantation. Complications post-explantation were rare but included temporary hypoglossal paresis.

Keywords

device removalhypoglossal nerveobstructive sleep apnea

Information

Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 139 , Issue 8 , August 2025 , pp. 655 - 662
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

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Footnotes

John Ming Ren Loh takes responsibility for the integrity of the content of the paper

Presented at event title, date month year, town/city, state abbreviation (if in USA), country.

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