The Rise of Upper Airway Stimulation in the Era of Transoral Robotic Surgery for Obstructive Sleep Apnea

Abstract

Introduced in 2010, transoral robotic surgery (TORS) is recognized as an effective treatment of moderate to severe obstructive sleep apnea (OSA) in the setting of lymphoid and muscular tongue base hypertrophy. Upper airway stimulation (UAS) or hypoglossal nerve stimulation has emerged as a promising treatment of patients with moderate to severe OSA who have failed continuous positive airway pressure. UAS has shown favorable success rates and low morbidity compared with traditional soft tissue and skeletal framework surgery. UAS is in its infancy as a surgical procedure and concerns exist regarding narrow candidacy criteria, postimplant device titration, and durability of treatment response.

Keywords: Hypoglossal nerve stimulation; Inspire; Obstructive sleep apnea; Transoral robotic surgery; Upper airway stimulation.