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Hypoglosse nerve stimulation

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https://www.readbyqxmd.com/read/28323640/a-micro-scale-printable-nanoclip-for-electrical-stimulation-and-recording-in-small-nerves
#1
Charles A Lissandrello, Winthrop F Gillis, Jun Shen, Ben W Pearre, Flavia Vitale, Matteo Pasquali, Bradley J Holinski, Daniel J Chew, Alice E White, Timothy J Gardner
OBJECTIVE: The vision of bioelectronic medicine is to treat disease by modulating the signaling of visceral nerves near various end organs. In small animal models, the nerves of interest can have small diameters and limited surgical access. New high-resolution methods for building nerve interfaces are desirable. In this study, we present a novel nerve interface and demonstrate its use for stimulation and recording in small nerves. APPROACH: We design and fabricate micro-scale electrode-laden nanoclips capable of interfacing with nerves as small as 50 µm in diameter...
March 21, 2017: Journal of Neural Engineering
https://www.readbyqxmd.com/read/28294946/continuing-the-original-stanford-sleep-surgery-protocol-from-upper-airway-reconstruction-to-upper-airway-stimulation-our-first-successful-case
#2
Stanley Yung Liu, Robert Wayne Riley
In 1993, a surgical protocol for dynamic upper airway reconstruction in patients with obstructive sleep apnea (OSA) was published, and it became commonly known as the Stanford phase 1 and 2 sleep surgery protocol. It served as a platform on which research and clinical studies have continued to perfect the surgical care of patients with OSA. However, relapse is inevitable in a chronic condition such as OSA, and a subset of previously cured surgical patients return with complaints of excessive daytime sleepiness...
February 20, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28126502/-therapeutic-alternatives-to-continuous-positive-airway-pressure-for-obstructive-sleep-apnea-hypopnea-syndrome
#3
Frédéric Gagnadoux, Marie Jouvenot, Nicole Meslier, Pascaline Priou, Wocjiech Trzepizur
Oral appliance therapy (OAT) is the main therapeutic alternative to continuous positive airway pressure (CPAP). OAT has been recommended as an appropriate first-line treatment option for moderate obstructive sleep apnea-hypopnea syndrome (OSAHS) in patients without severe cardiovascular comorbidity. The lower efficacy of OAT in reducing sleep-disordered breathing could be offset by a higher compliance relative to CPAP, resulting in similar health outcomes in terms of sleepiness, neurobehavioral functioning, quality of life and blood pressure...
January 23, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28105667/palatoglossus-coupling-in-selective-upper-airway-stimulation
#4
Clemens Heiser, Günther Edenharter, Murat Bas, Markus Wirth, Benedikt Hofauer
OBJECTIVES/HYPOTHESIS: Selective upper airway stimulation (sUAS) of the hypoglossal nerve is a useful therapy to treat patients with obstructive sleep apnea. Is it known that multiple obstructions can be solved by this stimulation technique, even at the retropalatal region. The aim of this study was to verify the palatoglossus coupling at the soft palate during stimulation. STUDY DESIGN: Single-center, prospective clinical trail. METHODS: Twenty patients who received an sUAS implant from April 2015 to April 2016 were included...
January 20, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28025918/outcomes-of-upper-airway-stimulation-for-obstructive-sleep-apnea-in-a-multicenter-german-postmarket-study
#5
Clemens Heiser, Joachim T Maurer, Benedikt Hofauer, J Ulrich Sommer, Annemarie Seitz, Armin Steffen
Objective Selective stimulation of the hypoglossal nerve is a new surgical therapy for obstructive sleep apnea, with proven efficacy in well-designed clinical trials. The aim of the study is to obtain additional safety and efficacy data on the use of selective upper airway stimulation during daily clinical routine. Study Design Prospective single-arm study. Setting Three tertiary hospitals in Germany (Munich, Mannheim, Lübeck). Subjects and Methods A multicenter prospective single-arm study under a common implant and follow-up protocol took place in 3 German centers (Mannheim, Munich, Lübeck)...
February 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/27858088/specific-branches-of-hypoglossal-nerve-to-genioglossus-muscle-as-a-potential-target-of-selective-neurostimulation-in-obstructive-sleep-apnea-anatomical-and-morphometric-study
#6
Philippe Delaey, Jérôme Duisit, Catherine Behets, Thierry Duprez, Pierre Gianello, Benoît Lengelé
PURPOSE: To determine the ideal implantation site for selective tongue neurostimulation in obstructive sleep apnea, anatomy of the distal branching of the hypoglossal nerve (HGN) was revisited. METHODS: The HGN distal course and intramuscular distribution to the tongue muscles were studied in 17 embalmed and 5 fresh heads (age 60-98, BMI 20-35). Medial branches supplying selectively the genioglossus (GG) muscle were identified. Then, the distinct bundles entering the oblique (GGo) and horizontal (GGh) parts of the GG were located...
November 17, 2016: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/27829262/-upper-airway-stimulation-in-osa
#7
B Bender
Anatomical basis of obstructive sleep apnea (OSA) is the collapse of the pharynx during sleep. It is considered as a result of complex interactions of structural and neuromuscular factors. Depth of sleep and body position have modulating effects. Although different areas of obstruction were identified, studies show that the sleep-mediated obstruction frequently occurs in the base of tongue area.Continuous positive airway pressure (CPAP) is the standard treatment for obstructive sleep apnea syndrome (OSAS) since more than 30 years...
November 2016: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/27762236/nerve-cuff-electrode-using-embedded-magnets-and-its-application-to-hypoglossal-nerve-stimulation
#8
Jungmin Seo, Jee Hye Wee, Jeong Hoan Park, Pona Park, Jeong-Whun Kim, Sung June Kim
OBJECTIVE: A novel nerve cuff electrode with embedded magnets was fabricated and developed. In this study, a pair of magnets was fully embedded and encapsulated in a liquid crystal polymer (LCP) substrate to utilize magnetic force in order to replace the conventional installing techniques of cuff electrodes. In vitro and in vivo experiments were conducted to evaluate the feasibility of the magnet-embedded nerve cuff electrode (MENCE). Lastly, several issues pertaining to the MENCE such as the cuff-to-nerve diameter ratio, the force of the magnets, and possible concerns were discussed in the discussion section...
December 2016: Journal of Neural Engineering
https://www.readbyqxmd.com/read/27732789/obstructive-sleep-apnea-update-and-future
#9
Diane C Lim, Allan I Pack
Obstructive sleep apnea (OSA) is a worldwide disease whose prevalence is increasing as obesity rates increase. The link between obesity and OSA is likely to be the deposition of fat in the tongue, compromising upper airway size. The role of obesity varies in different ethnic groups, with Chinese being particularly sensitive to increases in weight. OSA lends itself to a personalized approach to diagnosis and therapy. For example, different clinical OSA subtypes likely benefit from therapy in different ways. Hypoglossal nerve stimulation is a useful second-line therapy in patients who cannot tolerate continous positive airway pressure (CPAP) machines or intraoral devices...
January 14, 2017: Annual Review of Medicine
https://www.readbyqxmd.com/read/27720458/upper-airway-stimulation-therapy
#10
REVIEW
Katherine Koral Green, B Tucker Woodson
Traditional upper airway surgery directly modifies skeletal and soft tissue structures surrounding the airway to treat obstructive sleep apnea (OSA). Upper airway stimulation (UAS) attempts to treat upper airway obstruction and OSA by stimulating the hypoglossal nerve. The Inspire II implant has been approved for clinical UAS. Basic science data support that UAS prevents obstruction and improves airflow. Clinical results demonstrate that UAS improves respiratory sleep metrics and improves both objective and subjective self-reported sleep and quality-of-life outcomes...
December 2016: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27689226/-hypoglossal-nerve-stimulation-in-patients-with-cpap-failure-evolution-of-an-alternative-treatment-for-patients-with-obstructive-sleep-apnea
#11
C Heiser, B Hofauer
Obstructive sleep apnea (OSA) is a common disease in western industrialized countries with increasing prevalence. Gold standard of therapy is nocturnal positive pressure ventilation by continuous positive airway pressure (CPAP). Due to complications and side effects of ventilation, therapy adherence is limited. Recently an alternative surgical treatment has become available for these patients, which uses established techniques to stimulate the hypoglossus nerve to open the upper airway during sleep. The aim of this work is to provide an overview of the history and current state of scientific knowledge of this therapy in the treatment of OSA...
February 2017: HNO
https://www.readbyqxmd.com/read/27572120/upper-airway-stimulation-therapy-a-novel-approach-to-managing-obstructive-sleep-apnea
#12
REVIEW
Ryan J Soose, M Boyd Gillespie
OBJECTIVES: Review the role of upper airway stimulation (UAS) therapy in the management of moderate to severe obstructive sleep apnea (OSA). DATA SOURCES: A literature search was performed of PubMed and Medline using the search terms clinical trial; obstructive sleep apnea; upper airway stimulation; hypoglossal stimulation; hypoglossal nerve; Inspire; and ImThera. REVIEW METHODS: All published clinical trials of currently available devices were reviewed...
September 2016: Laryngoscope
https://www.readbyqxmd.com/read/27572119/updates-of-operative-techniques-for-upper-airway-stimulation
#13
REVIEW
Clemens Heiser, Erica Thaler, Maurits Boon, Ryan J Soose, B Tucker Woodson
Selective upper airway stimulation has been established as an additional treatment for obstructive sleep apnea (OSA). Essential for the treatment is the precise placement of the cuff electrode for select branches of the hypoglossal nerve, which innervate the protrusors and stiffeners of the tongue. A direct approach to the distal hypoglossal nerve has been established to achieve this goal. For surgeons, detailed knowledge of this anatomy is vital. Another decisive step is the placement of the sensing lead between the intercostal muscles...
September 2016: Laryngoscope
https://www.readbyqxmd.com/read/27435704/sternocleidomastoid-innervation-from-an-aberrant-nerve-arising-from-the-hypoglossal-nerve-a-prospective-study-of-160-neck-dissections
#14
Peter A Brennan, Peyman Alam, Mostafa Ammar, Constantine Tsiroyannis, Eirini Zagkou, Susan Standring
BACKGROUND: Anatomical variants of the spinal root of the accessory nerve and cervical plexus are well known but other variants are exceptionally rare. METHODS: A prospective study of 160 selective neck dissections was undertaken following an index case, where a presumed C1 nerve (travelling with the hypoglossal nerve) was found to innervate sternocleidomastoid (SCM). A search was subsequently made for this variant while not compromising the neck dissection surgery itself...
February 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/27424823/origins-of-and-implementation-concepts-for-upper-airway-stimulation-therapy-for-obstructive-sleep-apnea
#15
REVIEW
Kingman P Strohl M D, Jonathan Baskin M D, Colleen Lance M D, Diana Ponsky M D, Mark Weidenbecher M D, Madeleine Strohl B A, Motoo Yamauchi M D
Upper airway stimulation, specifically hypoglossal (CN XII) nerve stimulation, is a new, alternative therapy for patients with obstructive sleep apnea hypopnea syndrome who cannot tolerate positive airway pressure, the first-line therapy for symptomatic patients. Stimulation therapy addresses the cause of inadequate upper airway muscle activation for nasopharyngeal and oropharyngeal airway collapse during sleep. The purpose of this report is to outline the development of this first-in-class therapy and its clinical implementation...
July 2016: Respiratory Investigation
https://www.readbyqxmd.com/read/27411337/sonographic-evaluation-of-tongue-motions-during-upper-airway-stimulation-for-obstructive-sleep-apnea-a-pilot-study
#16
Benedikt Hofauer, Kingman Strohl, Andreas Knopf, Murat Bas, Markus Wirth, Konrad Stock, Clemens Heiser
INTRODUCTION: The objective was to evaluate the feasibility of sonographic evaluation of functional tongue motion as a tool to evaluate postoperative outcomes in human subjects using breathing-synchronized stimulation of the hypoglossal nerve-a novel therapy option for patients with obstructive sleep apnea (OSA). MATERIAL AND METHODS: Sixteen patients with OSA (n = 16, age 60.4 ± 10.2, BMI 28.7 ± 2.4, AHI 35.0 ± 11.8) underwent sonographic evaluation of tongue motion after initiation of therapy with the Inspire II Upper Airway Stimulation system...
July 13, 2016: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/27345949/nerve-monitoring-guided-selective-hypoglossal-nerve-stimulation-in-obstructive-sleep-apnea-patients
#17
Clemens Heiser, Benedikt Hofauer, Luke Lozier, B Tucker Woodson, Thomas Stark
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...
June 27, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27299890/recent-developments-in-the-diagnosis-and-treatment-of-obstructive-sleep-apnea-english-version
#18
B A Stuck, J T Maurer
Over the past few years, the diagnostic tools and therapeutic approaches for obstructive sleep apnea (OSA) have evolved further. Based on a review of the current literature and the personal experiences of the authors, the most relevant developments are summarized in this article and discussed with regard to their impact on the clinical management of the disease. In the third edition of the International Classification of Sleep Disorders, the classification of sleep-disordered breathing was modified. Notably, additional clinical criteria for the diagnosis of OSA were established and out-of-center sleep testing was introduced as an alternative to polysomnography...
January 2017: HNO
https://www.readbyqxmd.com/read/27244805/hypoglossal-nerve-stimulator-implantation-in-an-adolescent-with-down-syndrome-and-sleep-apnea
#19
Gillian R Diercks, Donald Keamy, Thomas Bernard Kinane, Brian Skotko, Allison Schwartz, Ellen Grealish, John Dobrowski, Ryan Soose, Christopher J Hartnick
Obstructive sleep apnea (OSA) is more common in children with Down syndrome, affecting up to 60% of patients, and may persist in up to 50% of patients after adenotonsillectomy. These children with persistent moderate to severe OSA require continuous positive airway pressure, which is often poorly tolerated, or even tracheotomy for severe cases. The hypoglossal nerve stimulator is an implantable device that produces an electrical impulse to the anterior branches of the hypoglossal nerve, resulting in tongue protrusion in response to respiratory variation...
May 2016: Pediatrics
https://www.readbyqxmd.com/read/27134515/treatments-for-obstructive-sleep-apnea
#20
Michael W Calik
OBJECTIVE: To review the efficacy of current treatment options for adults with obstructive sleep apnea (OSA). METHODS: Review of the literature. RESULTS: OSA, characterized by repetitive ≥ 10-second interruptions (apnea) or reductions (hypopnea) in airflow, is initiated by partial or complete collapse in the upper airway despite respiratory effort. When left untreated, OSA is associated with comorbid conditions, such as cardiovascular and metabolic diseases...
April 2016: Journal of Clinical Outcomes Management: JCOM
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