{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T17:40:47Z","timestamp":1778866847517,"version":"3.51.4"},"reference-count":21,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,2,11]],"date-time":"2022-02-11T00:00:00Z","timestamp":1644537600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:sec><jats:title>Objective(s)<\/jats:title><jats:p>Upper airway stimulator (UAS) placement is a treatment for obstructive sleep apnea (OSA) with few complications and low morbidity. UAS placement has traditionally been performed using a three\u2010incision approach, however, it has been implanted using a two\u2010incision approach. This approach could significantly decrease operation time without a difference in postoperative complications, demonstrating its safety and feasibility for UAS placement. The objective was to assess operative time and complication rate in the two\u2010incision approach for UAS placement compared to the three\u2010incision approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospectively reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who underwent UAS placement using the two\u2010 or three\u2010incision approach at a single academic institution from November 2014 to June 2021 were retrospectively reviewed. The two\u2010incision approach did not include the incision at the mid\u2010axillary line. Main outcome measures included operation time and complication rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three\u2010hundred forty\u2010eight patients underwent UAS placement. The three\u2010incision approach demonstrated an average operation time of 143.3\u2009minutes whereas the two\u2010incision approach averaged 129.4\u2009minutes (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). There was no significant difference in rate of postoperative complications between the two\u2010 and three\u2010incision cohorts including pneumothorax (0% vs. 0.4%, <jats:italic>P<\/jats:italic>\u2009&gt;\u2009.99), patient\u2010reported discomfort (5.6% vs. 6.5%, <jats:italic>P<\/jats:italic>\u2009&gt;\u2009.99), activity restriction (0% vs. 1.4%, <jats:italic>P<\/jats:italic>\u2009&gt;\u2009.50), and incisional pain (0.0% vs. 1.0%, <jats:italic>P<\/jats:italic>\u2009&gt;\u2009.99). No patients experienced incision site bleeding or infection. The two\u2010incision approach was associated with decreased rate of revision surgery (0.0% vs. 5.4%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.048).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The UAS two\u2010incision approach proved to have a significantly shorter operative time without an increase in complications as compared to the three\u2010incision approach. This approach is a safe and feasible option.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3 <jats:italic>Laryngoscope<\/jats:italic>, 132:1687\u20131691, 2022<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30050","type":"journal-article","created":{"date-parts":[[2022,2,11]],"date-time":"2022-02-11T10:13:49Z","timestamp":1644574429000},"page":"1687-1691","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["<scp>Two\u2010Incision<\/scp> Approach for Hypoglossal Nerve Stimulator Placement: A Single Institution Assessment"],"prefix":"10.1002","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4467-3277","authenticated-orcid":false,"given":"Emily S.","family":"Sagalow","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Thomas Jefferson University Hospital  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julianna","family":"Rodin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Thomas Jefferson University Hospital  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonard","family":"Estephan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Thomas Jefferson University Hospital  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jarrett","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Thomas Jefferson University Hospital  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meghan","family":"Crippen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Thomas Jefferson University Hospital  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurits","family":"Boon","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Thomas Jefferson University Hospital  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4637-3630","authenticated-orcid":false,"given":"Colin","family":"Huntley","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Thomas Jefferson University Hospital  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,2,11]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.3514"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00043.2008"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1513\/pats.200709-155MG"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.86.s1.02"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.11.069"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000132"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kws342"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-016-0156-0"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01405-2018"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818762383"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1308659"},{"key":"e_1_2_6_13_1","first-page":"412","article-title":"Hypoglossal nerve stimulation: effective Longterm therapy for obstructive sleep apnea","volume":"86","author":"Maresch KJ","year":"2018","journal-title":"AANA J"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.4736"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otot.2012.07.002"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23301"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26158"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2020.102585"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28950"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26808"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otot.2020.06.002"},{"key":"e_1_2_6_22_1","volume-title":"IBM SPSS statistics [Computer Software]. 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