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Scientific Oral Presentation

Sleep Medicine

Feasibility and Effectiveness of Combination Nasal Surgery and Hypoglossal Nerve Stimulation

Tuesday, October 20, 2026
8:24 AM - 8:30 AM PT
Location: 403B

    Presenting Author(s)

  • ES

    Elizabeth Sell, MD, MSc

    Resident Physician
    University of Pittsburgh Medical Center - Medical Education Program
    Pittsburgh, Pennsylvania, United States

    • Co-Author(s)

  • Olivier O. Bourguillon, MD

    Resident Physician
    University of Pittsburgh Medical Center
    PITTSBURGH, PA, Pennsylvania, United States

    • Senior Author(s)

  • Ryan J. Soose, MD

    Physician
    University of Pittsburgh Department of Otolaryngology
    Pittsburgh, Pennsylvania, United States

  • Thomas M. Kaffenberger, MD

    Physician
    University of Pittsburgh Department of Otolaryngology
    Pittsburgh, Pennsylvania, United States

Introduction: Nasal treatments are known to improve various obstructive sleep apnea (OSA) treatments, yet its role in hypoglossal nerve stimulation (HGNS) therapy is unexplored. Our objectives were to investigate the effectiveness of nasal surgery (turbinate reduction with or without septoplasty) and HGNS in patients with concomitant nasal obstruction and assess the additional surgical time requirement.

Methods: We performed a case-control study of patients with moderate-to-severe OSA and nasal obstruction. Patients who underwent HGNS and nasal surgery (turbinate reduction with or without septoplasty) were compared to a control group who underwent HGNS alone at a single academic institution. Total surgical times (from neck incision to last closure) were collected as were pre- and post-operative objective along with subjective measures of OSA severity. AHI, Epstein Sleepiness Scale (ESS) and nasal obstruction and septoplasty effectiveness (NOSE) questionnaires were collected pre- and post-operatively.

Results: Fifteen patients underwent HGNS+nasal surgery and had followup sleep testing for the current study. The control group was comprised of sixteen patients who underwent HGNS alone. Baseline demographics and OSA severity were similar between the two groups, although baseline OSA severity tended to be lower for patients undergoing HGNS+nasal surgery. Turbinate reduction with or without septoplasty resulted in significantly longer total operating times (min): HGNS 71 [64, 77] vs HGNS+nasal surgery 122 [106,137], 95% CI, p< 0.01. Decrease in ESS was comparable between both groups 2.6 [0.6, 4.6] vs 2.6 [-0.7, 6.0] (p=0.9). Patients who underwent HGNS+nasal surgery tended to have greater improvements in NOSE scores, although this decrease did not reach statistical significance: 0.9 [0.2, 1.7] vs 2.9 [-0.5, 6.4] (p=0.27).

Conclusions: Adding turbinate reduction with or without septoplasty may represent a promising strategy to improve concomitant nasal symptoms in patients with OSA undergoing HGNS.