Managing wound complications in hypoglossal nerve stimulation: Prevention strategies and criteria for avoiding device explantation

Hypoglossal nerve stimulation is a proven treatment for obstructive sleep apnea, yet its invasive nature raises concerns about wound complications. This case series examines three distinct postoperative scenarios: (1) early infection in a patient with poor glycemic control and inadequate self-care,...

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Main Authors: Kai-Yuan Hsiao, Martha Lucía Gutiérrez Pérez, Patrícia S. Cé, Thomaz Fleury Curado
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Oral and Maxillofacial Surgery Cases
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Online Access:http://www.sciencedirect.com/science/article/pii/S2214541925000136
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author Kai-Yuan Hsiao
Martha Lucía Gutiérrez Pérez
Patrícia S. Cé
Thomaz Fleury Curado
author_facet Kai-Yuan Hsiao
Martha Lucía Gutiérrez Pérez
Patrícia S. Cé
Thomaz Fleury Curado
author_sort Kai-Yuan Hsiao
collection DOAJ
description Hypoglossal nerve stimulation is a proven treatment for obstructive sleep apnea, yet its invasive nature raises concerns about wound complications. This case series examines three distinct postoperative scenarios: (1) early infection in a patient with poor glycemic control and inadequate self-care, (2) late-stage infection in a patient with prolonged device non-use, and (3) early wound dehiscence caused by nonadherence to postoperative restrictions, successfully managed with a novel wound management protocol that preserved the device. These cases highlight the importance of comprehensive risk assessment, adherence to postoperative guidelines, the control of metabolic diseases and individualized management strategies to preserve device functionality while reducing healthcare costs. Notably, this is the first report demonstrating successful device retention in hypoglossal nerve stimulation despite wound dehiscence. Further studies are essential to refine risk stratification and establish evidence-based treatment protocols for this innovative and increasingly utilized therapy.
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series Oral and Maxillofacial Surgery Cases
spelling doaj-art-5319c491d86a4c0d93ebbd627d10bc8b2025-08-20T03:12:39ZengElsevierOral and Maxillofacial Surgery Cases2214-54192025-06-0111210039810.1016/j.omsc.2025.100398Managing wound complications in hypoglossal nerve stimulation: Prevention strategies and criteria for avoiding device explantationKai-Yuan Hsiao0Martha Lucía Gutiérrez Pérez1Patrícia S. Cé2Thomaz Fleury Curado3Division of Oral and Maxillofacial Surgery, Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Otolaryngology – Head and Neck Surgery, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USAUniversidad El Bosque, Colombian School of Medicine, Otorhinolaryngology Interest Group UEB, Bogotá, ColombiaDivision of Oral and Maxillofacial Surgery, Department of Dentistry, University Hospital, Federal University of Santa Catarina, Brazil; Corresponding author. University Hospital Polydoro Ernani de São Tiago, Delfino Conti Street, Florianópolis / SC 88040-370, Trindade, Brazil.Department of Otolaryngology – Head and Neck Surgery, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USAHypoglossal nerve stimulation is a proven treatment for obstructive sleep apnea, yet its invasive nature raises concerns about wound complications. This case series examines three distinct postoperative scenarios: (1) early infection in a patient with poor glycemic control and inadequate self-care, (2) late-stage infection in a patient with prolonged device non-use, and (3) early wound dehiscence caused by nonadherence to postoperative restrictions, successfully managed with a novel wound management protocol that preserved the device. These cases highlight the importance of comprehensive risk assessment, adherence to postoperative guidelines, the control of metabolic diseases and individualized management strategies to preserve device functionality while reducing healthcare costs. Notably, this is the first report demonstrating successful device retention in hypoglossal nerve stimulation despite wound dehiscence. Further studies are essential to refine risk stratification and establish evidence-based treatment protocols for this innovative and increasingly utilized therapy.http://www.sciencedirect.com/science/article/pii/S2214541925000136Device explantationHyperglycemiaHypoglossal nerve stimulationObstructive sleep apneaWound complication
spellingShingle Kai-Yuan Hsiao
Martha Lucía Gutiérrez Pérez
Patrícia S. Cé
Thomaz Fleury Curado
Managing wound complications in hypoglossal nerve stimulation: Prevention strategies and criteria for avoiding device explantation
Oral and Maxillofacial Surgery Cases
Device explantation
Hyperglycemia
Hypoglossal nerve stimulation
Obstructive sleep apnea
Wound complication
title Managing wound complications in hypoglossal nerve stimulation: Prevention strategies and criteria for avoiding device explantation
title_full Managing wound complications in hypoglossal nerve stimulation: Prevention strategies and criteria for avoiding device explantation
title_fullStr Managing wound complications in hypoglossal nerve stimulation: Prevention strategies and criteria for avoiding device explantation
title_full_unstemmed Managing wound complications in hypoglossal nerve stimulation: Prevention strategies and criteria for avoiding device explantation
title_short Managing wound complications in hypoglossal nerve stimulation: Prevention strategies and criteria for avoiding device explantation
title_sort managing wound complications in hypoglossal nerve stimulation prevention strategies and criteria for avoiding device explantation
topic Device explantation
Hyperglycemia
Hypoglossal nerve stimulation
Obstructive sleep apnea
Wound complication
url http://www.sciencedirect.com/science/article/pii/S2214541925000136
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AT marthaluciagutierrezperez managingwoundcomplicationsinhypoglossalnervestimulationpreventionstrategiesandcriteriaforavoidingdeviceexplantation
AT patriciasce managingwoundcomplicationsinhypoglossalnervestimulationpreventionstrategiesandcriteriaforavoidingdeviceexplantation
AT thomazfleurycurado managingwoundcomplicationsinhypoglossalnervestimulationpreventionstrategiesandcriteriaforavoidingdeviceexplantation