Evidence map›Paper›PMID 39364004›Full record

ArticleOTO open

Implementing a Streamlined Hypoglossal Nerve Stimulator Pathway: Cost, Time to Surgery, and Outcomes.

Nicholas R Lenze, Jayden Garcia, Punithavathy Vijayakumar, Sonja G Schütz, Michael J Brenner, Jeffrey J Stanley, Paul T Hoff

Abstract read
In one paragraph

Article in OTO open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Out-of-Pocket Costs and Surprise Billing in Otolaryngology: A National Database Analysis.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2025
    Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Nicholas R LenzeDepartment of Otolaryngology-Head and Neck Surgery University of Michigan Medical School Ann Arbor Michigan USA.ORCID 0000-0002-2126-6663
Jayden GarciaDepartment of Otolaryngology-Head and Neck Surgery University of Michigan Medical School Ann Arbor Michigan USA.
Punithavathy VijayakumarDepartment of Neurology, Sleep Disorders Center University of Michigan Medical School Ann Arbor Michigan USA.
Sonja G SchützDepartment of Neurology, Sleep Disorders Center University of Michigan Medical School Ann Arbor Michigan USA.
Michael J BrennerDepartment of Otolaryngology-Head and Neck Surgery University of Michigan Medical School Ann Arbor Michigan USA.
Jeffrey J StanleyDepartment of Otolaryngology-Head and Neck Surgery University of Michigan Medical School Ann Arbor Michigan USA.
Paul T HoffDepartment of Otolaryngology-Head and Neck Surgery University of Michigan Medical School Ann Arbor Michigan USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: To evaluate the costs, time to surgery, and clinical outcomes associated with implementing a streamlined hypoglossal nerve stimulator (HGNS) implantation pathway. Study Design: Retrospective cohort study. Setting: Single tertiary care center in the United States from 2016 to 2023. Methods: Patients with a lack of complete concentric collapse of the velum during volitional snore on in-office laryngoscopy qualified for the streamlined HGNS pathway. This pathway consisted of confirmatory drug-induced sleep endoscopy (DISE) followed immediately by HGNS implantation during the same surgical encounter. Outcomes were compared to patients in the traditional pathway (standalone DISE followed by HGNS implantation on a later date). Results: A total of 68 patients (13 streamlined, 55 traditional) with obstructive sleep apnea who underwent HGNS implantation were included. Patients were predominately male (70.6%) and White (95.6%) and had a mean (SD) age of 63.5 (10.0) years. The streamlined pathway was associated with a significant reduction in both hospital costs (mean difference $9258, 95% confidence interval [CI]: 3690-14,825; Conclusion: In select patients, the streamlined HGNS pathway may expedite time to surgery and reduce hospital costs with comparable clinical outcomes to a traditional 2-stage pathway. Further research is warranted to validate patient selection and better understand longitudinal outcomes.

Indexed as

cost‐benefit analysiselectric stimulation therapyhospital costshypoglossal nerveobstructive sleep apneapatient‐reported outcome measurestime‐to‐treatment

Identifiers

PMID39364004
PMCPMC11447855

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.