HC 56/Male
HNS Implant

Diagnosis: Obstructive Sleep Apnoea

Severe OSA, long standing,
Reported tongue slipping back blocking the airway
- Previously known to another team. DISE 2020 (?Circumferential collapse). Trialled CPAP ~2021-2022, unable to tolerate despite different masks. Didn't feel rested despite use - sleep team documentaed as saying 'not effective' (?Ball-valving of tongue base/epiglottis)
- Trialled Sleepwell + custom Somnodent MADs - Didn't find helpful.
- Positional therapies, using rucksack to sleep on side
- Trialled Nastents - not effective
- Trialled iNAP device - variably helps
- PSG 2022 - AHI 42?
- Previous PSG 2013 - AHI 16.7, supine 38.6, non-supine 8.7
- Offered tonsillectomy + barbed wire pharyngoplasty + RFA tongue base 29/5/24 @ another centre to optimise for potential HNS, but concerned about risks and declined on the day of surgery > sought 2nd opinion for HNS

Pmh: Previous septoplasty, non-smoker, nil alcohol

Examination: BMI 24.8, mild retrognathia, grade 2 tonsils, no nasal obstruction



Previous Sleep study AHI>45 &
DISE, 4 years ago

Repeat sleep study (Dec 2024):
AHI (avg) = 30/hr
AHI (supine) = 66/hr
AHI (Non supine) = 29/hr
Min SpO2 = 84%

MDT discussion (May 2025) - To do Uptodate Insomnia scale. If no Insomnia, repeat DISE.

Repeat Insomnia score - 4 (No insomnia)

DISE (Aug 2025) - Complete AP palate and AP tongue base collapse supine and lateral - Suitable for HNS