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Sleep Medicine

(1312) Complications after Hypoglossal Nerve Stimulator Implantation

Saturday, October 17, 2026

Presenting Author(s)

DA

Deepthi S. Akella, DO MS

Resident Physician
University of Missouri-Columbia
Columbia, Missouri, United States

Co-Author(s)

Sarah Y. Atallah, BS

Medical Student
The University of Toledo College of Medicine and Life Sciences
Monclova, Ohio, United States
AI

Alexa F. Ibrahim, BA

Medical Student
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Oyster Bay, New York, United States

Senior Author(s)

Michele M. Carr, DDS MD MEd PhD

Professor
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Dept of Otolaryngology
Buffalo, NY, United States
Patrick T. Tassone, MD

Associate Professor of Otolaryngology
University of Missouri
Columbia, Missouri, United States

Introduction: Hypoglossal nerve stimulation (HGNS) is a highly utilized surgical treatment for patients with refractory obstructive sleep apnea (OSA). However, perioperative complications in a real-world setting outside of clinical trials are understudied. Our goal was to describe the surgical complications within 30 days after HGNS implantation.

Methods: A retrospective cohort study using the TriNetX database examining patients undergoing open implantation of HGNS (CPT Code 64582) for OSA was done. Inclusion criteria were adult patients implanted in January 2014 to January 2026. Surgical complications occurring within 30 days of surgery were included. Postoperative complications included hypoglossal nerve injury or repair (G52.3), wound infection (L00-L08, T81.4), hemorrhage, hematoma or seroma (L76.22, L76.3), and postoperative pain (G89, R52).

Results: A total of 11,314 patients were included. Mean age at implantation was 60.3 years and 7,217 patients (65%) were male. Of 11,314 patients, 143 (1.3%) experienced hypoglossal nerve injury or underwent hypoglossal nerve repair, 107 (0.9%) experienced infection of skin or subcutaneous tissue, 44 (0.4%) had hemorrhage, hematoma, or seroma, 484 (4.3%) reported postoperative pain, and there was a mortality of < 10 patients.

Conclusions: This retrospective, population-based study represents the largest real-world analysis of HGNS implantation and associated 30-day complications. Our findings show that serious perioperative complications were rare. HGNS appears to be a safe elective procedure in appropriately selected patients.