Portal de Periódicos da CAPES

Nerve monitoring–guided selective hypoglossal nerve stimulation in obstructive sleep apnea patients

2016; Wiley; Volume: 126; Issue: 12 Linguagem: Inglês

10.1002/lary.26026

1531-4995

Clemens Heiser, Benedikt Hofauer, Luke Lozier, B. Tucker Woodson, Thomas Stark,

Voice and Speech Disorders

Objective/Hypothesis Selective stimulation of the upper airway is a new therapy for obstructive sleep apnea. The aim of the study was to determine if a selective nerve integrity monitoring (NIM) system could aid in precise placement of the cuff electrode in selective upper‐airway stimulation. Study Design Single‐center, prospective clinical trial. Methods Twenty patients who received a selective upper‐airway stimulation system (Inspire Medical Systems, Maple Grove, MN) were implanted by using a NIM system. The tongue motions were recorded during surgery and 2 months postoperatively from the transoral view and by transnasal endoscopy. Results All patients exhibited consistent protrusion at tongue front and tongue base. The nerve monitoring system helped to place the cuff electrode around the protrusion and stiffening branches, while excluding the retractor branches of the hypoglossal nerve. Conclusion This report demonstrated a novel use of a NIM system to identify the functional separation between inclusion and exclusion branches of the hypoglossal nerve for implantation of a selective upper‐airway stimulation system. Level of Evidence 4. Laryngoscope , 126:2852–2858, 2016