HGNS Inspire(s) Next Gen Surgeons
“Let’s write something on hypoglossal nerve stimulation…comparing those who had prior interventions versus not.” —Dr. Corissa Chang, sometime in 2019.
I was Corissa’s research mentor at Stanford during her gap year, before she started medical school and oral & maxillofacial surgery (OMFS) residency at the University of Pennsylvania. Corissa showed early interest in the field of sleep-disordered breathing (SDB), and had previously won an American Association of Oral & Maxillofacial Surgery (AAOMS) research award with me.
That first project examined sex differences in patients presenting for sleep surgery. Our conclusion was one of admonition—we must stop using criteria based on men with obstructive sleep apnea (OSA) to evaluate women. Something is just not right when women have three times the odds of being on antidepressant and anti-anxiety medication, with a lower apnea-hypopnea index (AHI) after controlling for body-mass index (BMI), fatigue, and sleepiness.
Corissa’s next project with me on hypoglossal nerve stimulation (HGNS), also known as “Inspire,” involved examining my patients on the updated Riley-Powell Stanford Sleep Surgery Protocol and identifying those who were initially ineligible for HGNS, due to sleep endoscopy findings or elevated AHI. Depending on clinical findings of redundant soft palate, or maxillary or mandibular hypoplasia, these patients first undergo procedures such as uvulopalatopharyngoplasty (UPPP), distraction osteogenesis maxillary expansion (DOME), or maxillomandibular advancement (MMA). Repeat sleep study and sleep endoscopy then follow, to confirm both the need and eligibility for HGNS.
So how do these patients fare compared to matched subjects undergoing HGNS only? It turns out that they do better, despite beginning from a more severe starting point!
Congratulations, Corissa, for winning the 2024 Dr. David C. Stanton Award for the best resident research paper published in the Journal of Oral & Maxillofacial Surgery (JOMS) during the previous calendar year. Moreover, doing the AAOMS On the Go podcast with you at our annual meeting last week taught me the importance of a great acoustic system…
I look forward to following your trajectory as a rising academic surgeon and future teacher to many others. When you win the Stanton prize again, next time as a mentor, please give me a shout!
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