ArticleThe Laryngoscope2021
Transoral Versus Endoscopic Examination in Predicting Outcomes of Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea.
Article in The Laryngoscope, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Translating hypoglossal nerve stimulation tongue movement into functional response during drug-induced sleep endoscopy: a proof-of-concept study.Sleep & breathing = Schlaf & Atmung · 2026Article
- State-Dependent Biomechanical Behavior of Oropharyngeal Structures in Apneic and Control Subjects: A Proof-of-Concept Study.Annals of the American Thoracic Society · 2024Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
objectives/hypothesisTo examine the correlation between transoral and awake endoscopic examination and investigate their respective ability to predict outcomes of hypoglossal nerve stimulation (HGNS). STUDY
designRetrospective cohort study at a US medical center.
methodsSubjects were adults with apnea-hypopnea index (AHI) >15 events/hr who underwent HGNS according to standard indications. Eligible subjects had diagnostic preoperative sleep studies, full-night efficacy postoperative studies, as well as postoperative video recordings of transoral examination and awake endoscopy. Recordings were independently scored by two blinded reviewers. Cohen's κ coefficient, Student t test, and χ
resultsFifty-seven patients met all inclusion criteria. On average, patients were Caucasian, middle aged, and overweight. The mean preoperative AHI was 36.7 events/hr, which improved significantly to 18.3 events/hr following HGNS (P < .01). Overall, the response rate (defined as AHI reduction >50% and AHI < 20 events/hr) was 49%. There was slight correlation between transoral tongue protrusion and endoscopic tongue base movement (κ = 0.10). On transoral examination, patients with minimal/moderate tongue motion achieved a greater mean AHI reduction than patients with full motion (26.0 ± 18.0 vs. 12.8 ± 24.1, P = .02). In contrast, on awake endoscopy, patients with minimal/moderate tongue motion achieved a lesser mean AHI reduction than patients with full motion (8.7 ± 19.9 vs. 22.1 ± 22.7, P = .04).
conclusionsTransoral tongue protrusion bears an inverse relationship to HGNS success and correlates poorly with endoscopic tongue base movement. Endoscopic tongue base motion appears reflective of response to HGNS, with greater motion corresponding to greater AHI reduction. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:675-679, 2021.
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