(1355) Uvulopalatopharyngoplasty compared to Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea

Introduction: Obstructive Sleep Apnea (OSA) is a prevalent sleep disorder characterized by repetitive upper airway collapse, leading to disrupted sleep and significant morbidity. While uvulopalatopharyngoplasty (UPPP) has traditionally been the surgical mainstay for OSA, hypoglossal nerve stimulation (HGNS) has emerged as a less invasive alternative with promising results. This meta-analysis aims to compare the efficacy of UPPP monotherapy versus HGNS in reducing Apnea-Hypopnea Index (AHI) scores in patients with OSA.

Methods: A systematic review and meta analysis was conducted following PRISMA 2020 guidelines. A boolean search string was used to search Pubmed, Google Scholar, Web of Science, Embase, Cochrane Library, and Scopus. Included studies evaluated the Apnea-Hypopnea Index (AHI) for OSA patients treated with either UPPP or HGNS. A total of 365 patients among 9 randomized controlled trials were analyzed.

Results: Statistical analysis of available data revealed that HGNS (d = 1.545 p < 0.01) was higher than UPPP (d = 1.149 p < 0.01) when comparing preoperative and postoperative AHI scores. While there was a high level of heterogeneity (I2 > 0.87) HGNS showed marginally better results compared to UPPP.

Conclusions: Patients treated with HGNS demonstrated greater AHI improvement than UPPP patients in the context of OSA. These findings suggest that HGNS may be a viable alternative to UPPP for surgical management of OSA. However, due to differences between sample size and procedural differences between the studies, additional high-quality randomized controlled trials are needed to further evaluate the long-term efficacy, safety, and patient-centered outcomes of HGNS.