Ryan Nord, MD · Surgical learning
Three parallel pathways: one for each hypoglossal nerve stimulator, Inspire and Genio, and one for barbed reposition pharyngoplasty (BRP), the palate operation. Choose an operation to begin. All three follow the same format: step-by-step lessons from indications to closure, operative teaching media, self-checks, and a printable pre-case review.
Unilateral hypoglossal nerve stimulation
Bilateral hypoglossal nerve stimulation
Barbed reposition pharyngoplasty
Podcast corner
October 21, 2026 · 14 min
Chumpathong S, Mangmeesri P, Panyamee S, Banhiran W, Uataya M (author order partly scrambled by extraction; Uataya prints on the second author line). European Archives of Oto-Rhino-Laryngology 2026
Chumpathong and colleagues at Siriraj Hospital in Bangkok ran a small randomized, placebo-controlled trial asking whether nefopam, a non-opioid pain drug not approved in the United States, reduces morphine use in the first day after uvulopalatopharyngoplasty for obstructive sleep apnea. Added to a strong multimodal pain regimen, it did not: both groups needed only a few milligrams of morphine, with no statistically significant difference. Because the trial was underpowered, it supports not adding nefopam routinely while leaving a modest effect unexcluded.
October 21, 2026 · 13 min
Asghar M, Pang K, Asghar M, Rotenberg B. Head & Neck Surgery = le Journal D'oto-rhino-laryngologie et de Chir 2025
A 2025 systematic review from Rotenberg's group asked whether adults with obstructive sleep apnea can safely have nasal and palate surgery in ambulatory surgical centers and go home the same day. Across mostly older, hospital-based studies, unplanned admission for medical reasons averaged 5.4 percent across the four studies that reported it, above the authors' own 3 percent benchmark, and serious events were rare and came within the first few hours. The take-home point: the review maps early risk usefully but contains almost no true surgery-center data, so it does not yet justify moving pharyngoplasty patients out of overnight observation.
October 20, 2026 · 14 min
Badash I, Wong S, Biju K, Hur K, Commesso E, Kezirian EJ. Otolaryngology-Head and Neck Surgery 2025
A single-surgeon retrospective study by Badash and colleagues, with Kezirian as senior author, asked whether celecoxib or acetaminophen given around palate surgery for obstructive sleep apnea was associated with less opioid use in the first day after surgery. Higher celecoxib doses were associated with modestly lower opioid use, while acetaminophen showed no significant association, and 205 of 210 patients still received opioids. Because celecoxib became routine partway through the study period, the finding is one to watch for confirmation in a randomized trial.
Educational material for residents and clinicians. The pathways include real operative footage and photographs. They support preparation and discussion; they do not establish operative competence or replace supervised surgical training and the current device instructions. Site privacy notice.
Ryan Nord, MD, has served as a consultant for Inspire Medical Systems. He is a clinical investigator for Nyxoah, the maker of Genio, and a member of the clinical events committee for Nyxoah-sponsored trials. This is his personal educational website. The learning center adapts his teaching materials for resident education; it is not a manufacturer training credential. See the full disclosures for his industry relationships and how to report a content correction.