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Furthermore, obstructions at the soft palate level (upper obstructions) may be prevented through palatoglossal coupling as seen on sleep endoscopy. However, it has not been studied if the distribution of obstruction level during a whole night measurement is a relevant factor for the treatment outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Obstruction levels were measured with a manometry system during a whole night of sleep in 26 patients with OSA\u00a0(\n                      <jats:italic>f<\/jats:italic>\n                      \u2009=\u20091,\n                      <jats:italic>m<\/jats:italic>\n                      \u2009=\u200925; age 59.4\u2009\u00b1\u200911.3; BMI\u2009=\u200929.6\u2009\u00b1\u20093.6) either before (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20099) or after sHNS implantation (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200912). Five patients received a measurement before and after implantation. Obstructions were categorized into velar (soft palate and above), infravelar (below soft palate), and multilevel obstructions. An association between obstruction level and treatment outcome was calculated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean distribution of preoperative obstruction level could be divided into the following: 38% velar, 46% multilevel, and 16% infravelar obstructions. Patients with a good treatment response (defined as AHI\u2009&lt;\u200915\/h and AHI reduction of 50%) had fewer preoperative velar obstructions compared to non-responder\n                      <jats:italic>(<\/jats:italic>\n                      17% vs. 54%,\n                      <jats:italic>p<\/jats:italic>\n                      -value\u2009=\u20090.006)\n                      <jats:italic>.<\/jats:italic>\n                      In patients measured after sHNS implantation, a significantly higher rate of multilevel obstructions per hour was measured in non-responders (\n                      <jats:italic>p<\/jats:italic>\n                      -value\u2009=\u20090.012).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Selective hypoglossal nerve stimulation was more effective in patients with fewer obstructions at the soft palate level. Manometry may be a complementary diagnostic procedure for the selection of patients for HNS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11325-021-02396-y","type":"journal-article","created":{"date-parts":[[2021,6,5]],"date-time":"2021-06-05T19:14:22Z","timestamp":1622920462000},"page":"419-427","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Obstruction level associated with outcome in hypoglossal nerve stimulation"],"prefix":"10.1007","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7240-5363","authenticated-orcid":false,"given":"Markus","family":"Wirth","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Bautz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franziska","family":"von Meyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedikt","family":"Hofauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Strassen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clemens","family":"Heiser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,5]]},"reference":[{"issue":"4","key":"2396_CR1","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1016\/s2213-2600(15)00043-0","volume":"3","author":"R Heinzer","year":"2015","unstructured":"Heinzer R, Vat S, Marques-Vidal P, Marti-Soler H, Andries D, Tobback N, Mooser V, Preisig M, Malhotra A, Waeber G, Vollenweider P, Tafti M, Haba-Rubio J (2015) Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. 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Eur Arch Otorhinolaryngol 274(3):1727\u20131734. https:\/\/doi.org\/10.1007\/s00405-016-4297-6","journal-title":"Eur Arch Otorhinolaryngol"}],"container-title":["Sleep and Breathing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11325-021-02396-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11325-021-02396-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11325-021-02396-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,18]],"date-time":"2022-02-18T19:37:02Z","timestamp":1645213022000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11325-021-02396-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,5]]},"references-count":38,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,3]]}},"alternative-id":["2396"],"URL":"https:\/\/doi.org\/10.1007\/s11325-021-02396-y","relation":{},"ISSN":["1520-9512","1522-1709"],"issn-type":[{"value":"1520-9512","type":"print"},{"value":"1522-1709","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,5]]},"assertion":[{"value":"25 July 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 March 2021","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 May 2021","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 June 2021","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by local ethics committee of the Technical University of Munich (project number 96\/17S).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Markus Wirth, Benedikt Hofauer, and Clemens Heiser received financial research support\/grant and surgical training support from Inspire Medical Systems Inc. Clemens Heiser was a consultant for Inspire Medical Systems Inc.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}