A novel nasopharyngeal stent for the treatment of obstructive sleep apnea: a case series of nasopharyngeal stenting versus continuous positive airway pressure
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The objective of the study was to investigate the first-night treatment success of a nasopharyngeal stent compared to standard nCPAP-titration. This is a case series and a single-center study. Eight participants (n = 8) were selected with untreated obstructive sleep apnea with a prestudy AHI ≥10. A newly developed nasopharyngeal stent was tested individually versus standard nCPAP-titration. Cardiorespiratory polysomnography was performed on two consecutive nights (random order: stent, nCPAP). The AHI, the number of obstructive apneas and hypopneas, the mean oxygen saturation, and the minimum oxygen saturation were compared before and after using the nasopharyngeal stent or standard nCPAP. The AHI value before treatment (AHIpre) was 31.1 ± 12.0 (mean ± standard deviation). After inserting the AlaxoStent, the mean AHIstent was 19 ± 12.0 compared to mean AHInCPAP 8.2 ± 11.9 with standard nCPAP-titration. Both nasopharyngeal stenting and nCPAP-titration could reduce the mean number of obstructive apneas by >94 %. Compared to responder rates of classic surgical interventions like uvulopalatopharyngoplasty or multi-level surgery, the nasopharyngeal stent seems to give a comparable responder rate of 50 %. There were no complications associated with the use of the stent and it was well tolerated by all subjects. Nasopharyngeal stenting widens the range of non-invasive mechanical treatment and seems to be an effective mechanical therapeutic alternative to surgery in nCPAP non-compliant patients with OSA. Careful selection of the patient population is a prerequisite of treatment and therefore it should be reserved for individual cases only.
KeywordsObstructive sleep apnea Nasopharyngeal stent nCPAP incompliance Non-CPAP therapies
Additional Study investigator: Florian Ruberg MD, Private Practice for Otorhinolaryngology, Neustadt, Germany. Data analysis: Philipp, Grundtner, Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg.
Compliance with ethical statement
Conflict of interest
The authors have no funding, financial relationships, or conflicts of interest to disclose.
All procedures performed in the study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 5.Giles TL, Lasserson TJ, Smith BH et al (2006) Continuous positive airways pressure for obstructive sleep apnoea in adults. Cochrane Database Syst Rev (3):CD001106Google Scholar
- 7.Iber C, Ancoli-Israel S, Chesson A et al (2007) The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications, 1st edn. American Academy of Sleep Medicine, WestchesterGoogle Scholar
- 10.Kushida CA, Chediak A, Berry RB et al (2008) Clinical guidelines for the manual titration of positive airway pressure in patients with obstructive sleep apnea. J Clin Sleep Med JCSM Off Pub Am Acad Sleep Med 4:157–171Google Scholar
- 14.Powell HR, Watson NA, Kotecha BT (2014) Pilot study assessing the efficacy of a novel treatment for sleep related breathing disorders in patients undergoing sleep nasendoscopy. Clin Otolaryngol Off J ENT-UK Off J Neth Soc Otorhinolaryngol Cervicofac SurgGoogle Scholar
- 15.Randerath WJ, Verbraecken J, Andreas S et al (2011) Non-CPAP therapies in obstructive sleep apnoea. Eur Respir J Off J Eur Soc Clin Respir Physiol 37:1000–1028Google Scholar