{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:07:05Z","timestamp":1793383625656,"version":"4.5.0"},"reference-count":11,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,6,25]],"date-time":"2019-06-25T00:00:00Z","timestamp":1561420800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Inspire Medical Systems, Inc"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine whether previous palate or hypopharyngeal surgery was associated with efficacy of treatment of obstructive sleep apnea with hypoglossal nerve stimulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Cohort (retrospective and prospective).<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Eleven academic medical centers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Adults treated with hypoglossal nerve stimulation were enrolled in the ADHERE Registry. Outcomes were defined by the apnea\u2010hypopnea index (AHI), in 3 ways: change in the AHI and 2 definitions of therapy response requiring \u226550% reduction in the AHI to a level &lt;20 events\/h (Response20) or 15 events\/h (Response15). Previous palate and hypopharyngeal (tongue, epiglottis, or maxillofacial) procedures were documented. Linear and logistic regression examined the association between previous palate or hypopharyngeal surgery and outcomes, with adjustment for age, sex, and body mass index.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The majority (73%, 217 of 299) had no previous palate or hypopharyngeal surgery, while 25% and 9% had previous palate or hypopharyngeal surgery, respectively, including 6% with previous palate and hypopharyngeal surgery. Baseline AHI (36.0 \u00b1 15.6 events\/h) decreased to 12.0 \u00b1 13.3 at therapy titration (<jats:italic>P<\/jats:italic> &lt;. 001) and 11.4 \u00b1 12.6 at final follow\u2010up (<jats:italic>P<\/jats:italic> &lt;. 001). Any previous surgery, previous palate surgery, and previous hypopharyngeal surgery were not clearly associated with treatment response; for example, any previous surgery was associated with a 0.69 (95% CI: 0.37, 1.27) odds of response (Response20\u00a0measure) at therapy titration and a 0.55 (95% CI: 0.22, 1.34) odds of response (Response20\u00a0measure) at final follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Previous upper airway surgery was not clearly associated with efficacy of hypoglossal nerve stimulation.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599819856339","type":"journal-article","created":{"date-parts":[[2019,6,25]],"date-time":"2019-06-25T10:38:16Z","timestamp":1561459096000},"page":"897-903","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Previous Surgery and Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea"],"prefix":"10.1002","volume":"161","author":[{"given":"Eric J.","family":"Kezirian","sequence":"first","affiliation":[{"name":"Keck School of Medicine of the University of Southern California Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clemens","family":"Heiser","sequence":"additional","affiliation":[{"name":"Klinikum rechts der Isar Technical University of Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armin","family":"Steffen","sequence":"additional","affiliation":[{"name":"University of Lubeck Lubeck Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurits","family":"Boon","sequence":"additional","affiliation":[{"name":"Thomas Jefferson University Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedikt","family":"Hofauer","sequence":"additional","affiliation":[{"name":"Klinikum rechts der Isar Technical University of Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Doghramji","sequence":"additional","affiliation":[{"name":"Thomas Jefferson University Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim T.","family":"Maurer","sequence":"additional","affiliation":[{"name":"University\u2010Hospital Mannheim Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Ulrich","family":"Sommer","sequence":"additional","affiliation":[{"name":"Helios University Hospital Wuppertal Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan J.","family":"Soose","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Schwab","sequence":"additional","affiliation":[{"name":"University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Thaler","sequence":"additional","affiliation":[{"name":"University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirk","family":"Withrow","sequence":"additional","affiliation":[{"name":"University of Alabama Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Kominsky","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher G.","family":"Larsen","sequence":"additional","affiliation":[{"name":"University of Kansas Medical Center Kansas City Kansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Hsia","sequence":"additional","affiliation":[{"name":"University of Minnesota Fairview Hospital Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reena","family":"Mehra","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina","family":"Waters","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Cleveland Ohio 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