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Objectives: The influence of apnea‐ and hypopnea‐predominance on hypoglossal nerve stimulation therapy outcomes (HGNS) is still poorly defined. We assessed the significance of apnea‐ and hypopnea‐predominance in HGNS outcomes. Study Design: Case series with chart review. Setting: Single‐institution tertiary care center. Methods: A total of 216 subjects were included, all of which had undergone drug‐induced sleep endoscopy (DISE) and HGNS implantation. Demographic and polysomnographic data were collected. The 4% apnea‐hypopnea criteria were used to calculate apnea‐hypopnea index (AHI). Central apneas were omitted. Univariate logistic and linear regression were used to study the association between these data and apnea‐predominance and hypopnea‐predominance. Kruskal‐Wallis rank sum test was used to compare medians between groups for DISE collapse patterns. Results: Sixty‐three patients were apnea‐predominant, and 153 patients were hypopnea‐predominant. These 2 groups were similar demographically (p >.20). There was no significant difference in HGNS outcomes between the groups assessed using Sher20 criteria at the 1‐year mark using all‐night, single‐setting polysomnography or home sleep studies. Apnea index (AI)/AHI and reduction in AHI from preoperative to titration were significantly associated (p =.046). The median preoperative hypopnea index was significantly lower (p =.033) in subjects with no oropharyngeal collapse than patients with partial or complete oropharyngeal collapse. There were no significant relationships between AI/AHI and the different degrees of collapse at the velopharynx, oropharynx, tongue base, or epiglottis. Conclusions: In line with CPAP, tonsillectomy, and mandibular advancement therapy studies, we found there was largely no significant difference in DISE anatomy or in HGNS treatment outcomes between apnea‐ and hypopnea‐predominant individuals. [ABSTRACT FROM AUTHOR]

Sentinel lymph node mapping in patients with axillary breast carcinoma is technically challenging and poorly described in the literature. We report a patient with primary ectopic breast carcinoma of the axilla in whom concurrent peri‐tumoral and intra‐tumoral injection of radionuclide tracer allowed for identification and biopsy of sentinel lymph nodes. [ABSTRACT FROM AUTHOR]