Persistent OSA After Maxillomandibular Advancement: Insights From Drug-Induced Sleep Endoscopy.

Objective: To examine drug-induced sleep endoscopy (DISE) findings in individuals with persistent obstructive sleep apnea (OSA) after maxillomandibular advancement (MMA).

Study Design: Cross-sectional.

Setting: Academic medical center.

Anteroposterior and Lateral Epiglottis-Related Obstruction in Adult Obstructive Sleep Apnea.

Importance: Epiglottis-related airway obstruction in obstructive sleep apnea is uniquely identified during drug-induced sleep endoscopy (DISE) and may be associated with poorer treatment outcomes.

Objective: To determine whether specific demographic factors, awake physical examination, and DISE findings are associated with anteroposterior and/or lateral configurations of epiglottis-related airway obstruction during DISE.

Design, Setting, And Participants: This cross-sectional study including adults with obstructive sleep apnea undergoing DISE with prospective data collection from 2015 to 2025 was performed at 2 academic medical centers.

Bilateral hypoglossal nerve stimulation for obstructive sleep apnea: a nonrandomized clinical trial.

Study Objectives: To evaluate the safety and efficacy of a novel bilateral hypoglossal nerve stimulation (HNS) device for the treatment of OSA.

Methods: Adult patients with moderate-to-severe OSA who refused, failed, or did not tolerate positive airway pressure therapy underwent implantation and nightly use of HNS. The co-primary endpoints at 12 months were 1) a minimum of 50% reduction in the 4% apnea-hypopnea index (AHI) from baseline with a final AHI of less than 20 events/h, and 2) a minimum of 25% reduction in the 4% oxygen desaturation index (ODI).

Hypoglossal Nerve Stimulation Respiratory Lead Migration: MAUDE Database Review and Case Report.

Objective: Unilateral hypoglossal nerve stimulation (HGNS) to treat obstructive sleep apnea involves implantation of a pulse generator, a respiratory sensing lead, and a stimulation lead. Complications may arise related to all components. Previous studies have presented the overall incidence of reported adverse events.

Adherence to unilateral hypoglossal nerve stimulation and changes in Epworth Sleepiness Scale scores.

Study Objectives: Effective treatment of obstructive sleep apnea depends on efficacy and adherence. The objective of this analysis was to examine the association between adherence to unilateral hypoglossal nerve stimulation (Inspire upper airway stimulation) and changes in daytime sleepiness.

Methods: Participants were adults treated with unilateral hypoglossal nerve stimulation enrolled in the ADHERE Registry.

Obstructive Sleep Apnea Surgery Practice Patterns in the United States: 2019.

Objective: This study aims to determine the volumes and facility costs/charges for procedures used to treat the pharyngeal airway in adults with obstructive sleep apnea (OSA) in the United States in 2019, and to explore whether specific patient and facility characteristics are associated with procedure type and costs/charges.

Study Design: A cross-sectional study.

Setting: Nationwide databases (National Inpatient Sample and the Nationwide Ambulatory Surgery Sample).

Selective Adipose Cryolysis for Reduction of Lingual Tissue in a Porcine Model.

Objectives: Oropharyngeal fat volume is associated with obstructive sleep apnea (OSA) severity. Selective adipose cryolysis may produce cold-induced adipose cell death while sparing surrounding tissues. This study explored (1) similarities in tongue fat between porcine and human models and (2) the feasibility and potential reduction of lingual fat using selective adipose cryolysis.

Reprogramming human B cells with custom heavy-chain antibodies.

The immunoglobulin locus of B cells can be reprogrammed by genome editing to produce custom or non-natural antibodies that are not induced by immunization. However, current strategies for antibody reprogramming require complex expression cassettes and do not allow for customization of the constant region of the antibody. Here we show that human B cells can be edited at the immunoglobulin heavy-chain locus to express heavy-chain-only antibodies that support alterations to both the fragment crystallizable domain and the antigen-binding domain, which can be based on both antibody and non-antibody components.

Palate Shape, Drug-Induced Sleep Endoscopy Findings, and Obstructive Sleep Apnea Pharyngeal Surgery Outcomes.

Objective: Pharyngeal surgery is a treatment option for patients with obstructive sleep apnea (OSA) unable to tolerate positive pressure therapy. This study aims to determine the association between palate shape as described by Woodson and pharyngeal surgical outcomes.

Study Design: Exploratory analysis of retrospective cohort.

Advanced Diagnostic Techniques in Obstructive Sleep Apnea.

Optimal surgical and medical management of obstructive sleep apnea (OSA) requires clinically reliable identification of patterns and sites of upper airway obstruction. A wide variety of modalities has been used to evaluate upper airway obstruction. Drug-induced sleep endoscopy (DISE) and cine MRI are increasingly used to identify upper airway obstruction sites, to characterize airway obstruction patterns, to determine optimum medical and surgical treatment, and to plan individualized surgical management.

In reference to Impact of Insomnia on Hypoglossal Nerve Stimulation Outcomes in the ADHERE Registry.

Hypoglossal nerve stimulation is an important treatment for obstructive sleep apnea (OSA). Many patients with OSA also have insomnia. A recent study has suggested that outcomes of hypoglossal nerve stimulation are no worse (and may be better) in individuals with comorbid OSA and insomnia.

Advanced Diagnostic Techniques in Obstructive Sleep Apnea.

Optimal surgical and medical management of obstructive sleep apnea requires clinically reliable identification of patterns and sites of upper airway obstruction. A wide variety of modalities have been used to evaluate upper airway obstruction. Drug-induced sleep endoscopy (DISE) and cine MRI are increasingly used to identify upper airway obstruction sites, to characterize airway obstruction patterns, to determine optimum medical and surgical treatment, and to plan individualized surgical management.

Palate shape is associated with Unilateral Hypoglossal Nerve Stimulation Outcomes.

Objective: The aim was to determine the potential association between palate shape and unilateral hypoglossal nerve stimulation (HNS) outcomes.

Methods: Preoperative drug-induced sleep endoscopy (DISE) videos were reviewed and scored by 3 blinded reviewers to determine airway narrowing at the hard-soft palate junction (HP), soft palate genu, and inferior velum, as described by Woodson (2014). Scoring was as follows: 1-open airway, 2-narrow, 3-severe narrowing.

Reprogramming human B cells with custom heavy chain antibodies.

We describe a genome editing strategy to reprogram the immunoglobulin heavy chain (IgH) locus of human B cells to express custom molecules that respond to immunization. These heavy chain antibodies (HCAbs) comprise a custom antigen-recognition domain linked to an Fc domain derived from the IgH locus and can be differentially spliced to express either B cell receptor (BCR) or secreted antibody isoforms. The HCAb editing platform is highly flexible, supporting antigen-binding domains based on both antibody and non-antibody components, and also allowing alterations in the Fc domain.

Reprogramming human B cells with custom heavy chain antibodies.

We describe a genome editing strategy to reprogram the immunoglobulin heavy chain (IgH) locus of human B cells to express custom molecules that respond to immunization. These heavy chain antibodies (HCAbs) comprise a custom antigen-recognition domain linked to an Fc domain derived from the IgH locus and can be differentially spliced to express either B cell receptor (BCR) or secreted antibody isoforms. The HCAb editing platform is highly flexible, supporting antigen-binding domains based on both antibody and non-antibody components, and also allowing alterations in the Fc domain.

Developing a Social Media Ontology Across Otolaryngology and its Subspecialties.

Objective: To determine how social media is used in the dissemination of new information within otolaryngology, and to emphasize the importance of standardizing Twitter hashtag use.

Methods: Based on the 2019 SCImago journal rankings, the Twitter posts from the accounts of the top three journals covering each otolaryngology subspecialty were reviewed from August 1, 2020 to May 1, 2021. Twitter posts from the primary otolaryngology-related academic societies were also reviewed during this timeframe.

International Consensus Statement on Obstructive Sleep Apnea.

Background: Evaluation and interpretation of the literature on obstructive sleep apnea (OSA) allows for consolidation and determination of the key factors important for clinical management of the adult OSA patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International Consensus statement on Obstructive Sleep Apnea (ICS:OSA).

Methods: Using previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence-based review (EBR), or evidence-based review with recommendations (EBR-R) formats.

Altered regional cerebral blood flow in obstructive sleep apnea is associated with sleep fragmentation and oxygen desaturation.

Altered cerebral perfusion has been reported in obstructive sleep apnea (OSA). Using dynamic susceptibility contrast MRI, we compared cerebral perfusion between male OSA patients and male healthy reference subjects and assessed correlations of perfusion abnormalities of OSA patients with sleep parameters and neuropsychological deficits at 3 T MRI, polysomnography and neuropsychological tests in 68 patients with OSA and 21 reference subjects. We found lower global and regional cerebral blood flow and cerebral blood volume, localized mainly in bilateral parietal and prefrontal cortices, as well as multiple focal cortical and deep structures related to the default mode network and attention network.

Drug-Induced Sleep Endoscopy and Hypoglossal Nerve Stimulation Outcomes: A Multicenter Cohort Study.

Objectives/hypothesis: To determine the association between findings of blinded reviews of preoperative drug-induced sleep endoscopy (DISE) and outcomes of hypoglossal nerve stimulation (HNS) for obstructive sleep apnea (OSA).

Study Design: Cohort study.

Methods: A retrospective, multicenter cohort study of 343 adults who underwent treatment of OSA with HNS from 10 academic medical centers was performed.

Transoral Robotic Surgery (TORS) Versus Non-TORS Tongue Resection for Obstructive Sleep Apnea.

Objective: To compare transoral robotic surgery (TORS) versus non-TORS tongue resection procedures performed for obstructive sleep apnea from January 2010 to September 2015 using a national database, focusing on patient characteristics, performance of concurrent procedures, operative time, length of hospital stay, and postoperative complications.

Methods: A cohort of adults undergoing TORS and non-TORS tongue resection procedures was identified in the Nationwide Inpatient Sample, a publicly-available national administrative database incorporating a stratified sample of hospital discharge records. Outcomes were annual case volumes, prolonged (≥3 days) hospital stay, and complications.