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Abstract:
OBJECTIVES/HYPOTHESIS:Hypoglossal nerve stimulation (HGNS) effectively treats obstructive sleep apnea in select patients. Drug-induced sleep endoscopy (DISE) is required for HGNS candidacy. Data suggest that mandibular advancement (MA) devices and HGNS share similar target populations. We aimed to test the association between MA's effect on the velum and lateral walls during DISE in relation to the improvement in the apnea-hypopnea index (AHI) with HGNS. STUDY DESIGN:Prospective case series METHODS: All patients completed preoperative polysomnography or home sleep study, DISE with MA prior to HGNS implantation, and full-night efficacy sleep tests. Adult patients with body mass index (BMI) ≤ 35 and AHI ≥ 15 were included. Two independent reviewers scored DISE videos. RESULTS:Forty-six patients were included from October 2015 to January 2019. Mean BMI (standard deviation) was 28.5 (3.7) kg/m2 . Patients with a reduced airway response to MA had greater AHI improvement than patients with a robust response (21.7, 95% confidence interval [CI]: 14.4 to 29.0 vs. 4.9, 95% CI: -8.9 to 18.6; P = .03). Patients with complete baseline collapse at the velum and lateral walls (n = 11) had less response compared to those with partial collapse (n = 35) (AHI reduction of 4.4 [95% CI: -8.6 to 17.4] vs. 22.3 [95% CI: 15.1 to 29.6; P = .02]). CONCLUSIONS:Patients having significant airway improvement in the upper pharynx with MA during DISE appear less likely to succeed with HGNS. This phenomenon might be secondary to the worsened baseline obstruction of the upper pharynx in such patients. LEVEL OF EVIDENCE:4 Laryngoscope, 2020.
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最新影响因子:2.97 | 期刊ISSN:0023-852X | CiteScore:2.37 |
出版周期:Monthly | 是否OA:YES | 出版年份:1896 |
期刊官方网址:http://onlinelibrary.wiley.com/journal/10.1002/%28ISSN%291531-4995
自引率:10.50% | 研究方向:医学-耳鼻喉科学 |
出版地区:UNITED STATES |
SCI期刊coverage:Science Citation Index Expanded(科学引文索引扩展)
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For more than 100 years, otolaryngologists, clinicians, and researchers around the world have read The Laryngoscope to keep pace with and learn how to take advantage of the most important advances in the diagnosis and treatment of head and neck disorders. Moreover, the journal is the first choice among otolaryngologists to publish their most important findings and share their own successful techniques with their colleagues.
100多年来,世界各地的耳鼻喉科医生、临床医生和研究人员都阅读喉镜,以跟上并学习如何利用头颈部疾病诊断和治疗方面最重要的进展。此外,该杂志是耳鼻喉科医生的第一选择,发表他们最重要的发现,并与他们的同事分享他们自己的成功技术。
大类(学科) | 小类(学科) | 学科排名 |
医学 |
MEDICINE, RESEARCH & EXPERIMENTAL (医学:研究与实验) 4区 OTORHINOLARYNGOLOGY (耳鼻喉科学) 3区 |
73/133 12/41 |
年度总发文量 | 年度论文发表量 | 年度综述发表量 |
483 | 442 | 41 |
引文计数(2018)
文献(2015-2017)
4357次引用
1837篇文献
序号 | 类别 | 排名 | 百分位 |
1 |
大类(学科):Medicine
小类(学科):Otorhinolaryngology
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发表一篇学和医学成像类SCI论文
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