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Hypoglosse nerve stimulation

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https://www.readbyqxmd.com/read/28777178/sleep-disordered-breathing
#1
Nancy R Foldvary-Schaefer, Tina E Waters
PURPOSE OF REVIEW: Sleep-disordered breathing encompasses a broad spectrum of sleep-related breathing disorders, including obstructive sleep apnea (OSA), central sleep apnea, as well as sleep-related hypoventilation and hypoxemia. Diagnostic criteria have been updated in the International Classification of Sleep Disorders, Third Edition and the American Academy of Sleep Medicine Manual for Scoring Sleep and Associated Events. Neurologic providers should have basic knowledge and skills to identify at-risk patients, as these disorders are associated with substantial morbidity, the treatment of which is largely reversible...
August 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28771734/modified-surgical-approach-to-hypoglossal-nerve-stimulator-implantation-in-the-pediatric-population
#2
Sarah N Bowe, Gillian R Diercks, Christopher J Hartnick
Upper airway stimulation with the hypoglossal nerve stimulator is a promising treatment modality for severe obstructive sleep apnea in carefully selected patients with Down syndrome. The pediatric population presents a greater variety in body habitus, including thorax size. A modified surgical approach, utilizing a medially placed, single chest incision, instead of two separate chest incisions, provides an alternative that is particularly useful for pediatric patients with small stature. As this technology is evaluated for Food and Drug Administration clearance in the pediatric population, it is important to consider modifications in surgical technique, partnering prior surgical experience with the technical support of company representatives...
August 3, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28755767/hypoglossal-nerve-stimulation-surgery-for-obstructive-sleep-apnoea-our-preliminary-experience
#3
Peter Baptista, Octavio Garaycochea, Laura Álvarez-Gómez, Juan Alcalde, Manuel Alegre, Elena Urrestarazu
The objective of this communication is to describe our preliminary results in upper airway stimulation surgery via hypoglossal nerve stimulation implantation for obstructive sleep apnoea. We describe 4 cases and the outcomes of the surgery were analysed using the Epworth scale, apnoea-hypopnoea index, minimal O2 Sat, average O2 Sat and snoring intensity. In all cases a significant reduction in Epworth scale values and apnoea-hypopnoea index were obtained (P<.05). The minimum and average oxygen saturation had better values after the surgery, however, there was no statistically significant difference...
July 26, 2017: Acta Otorrinolaringológica Española
https://www.readbyqxmd.com/read/28738358/innovative-surgery-for-obstructive-sleep-apnea-nerve-stimulator
#4
J Ulrich Sommer, Karl Hörmann
Obstructive sleep apnea (OSA) as a multifactorial disease is treated with continuous positive airway pressure (CPAP) as the gold standard. Yet, if patients suffer from CPAP incompliance, traditional OSA surgery only targets morphological changes of the upper airway while neglecting functional issues. With the advent of upper airway stimulation, and in particular hypoglossal nerve stimulation as a treatment option, a highly effective, clinically proven and functional therapy with good evidence is available. This article gives a comprehensive overview of current and upcoming hypoglossal nerve stimulation systems (Inspire, ImThera, and Nyxoah), the specific advantages of this approach, the selection criteria and screening process, relevant clinical data, and a description of the different implantation procedures...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28730908/electrical-stimulation-for-the-treatment-of-obstructive-sleep-apnoea-a-review-of-the-evidence
#5
Valeria Bisogni, Martino F Pengo, Andrea De Vito, Giuseppe Maiolino, Gian Paolo Rossi, John Moxham, Joerg Steier
Obstructive sleep apnoea is an increasingly prevalent clinical condition with significant impact on individuals and public health. Continuous positive airway pressure therapy is the standard treatment, but adherence is limited and alternative treatments are needed. In this context, non-invasive and invasive methods for the electrical stimulation of upper airway dilator muscles have been demonstrated to be effective in selected patients. Areas covered: This review will cover investigations on the clinical effects, safety, and tolerability of non-invasive and invasive electrical stimulation of the upper airway for the management of obstructive sleep apnoea...
September 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28715374/in-vivo-evaluation-of-the-mechanical-and-viscoelastic-properties-of-the-rat-tongue
#6
Emanuele Loro, Stephen H Wang, Richard J Schwab, Tejvir S Khurana
The tongue is a highly innervated and vascularized muscle hydrostat on the floor of the mouth of most vertebrates. Its primary functions include supporting mastication and deglutition, as well as taste-sensing and phonetics. Accordingly, the strength and volume of the tongue can impact the ability of vertebrates to accomplish basic activities such as feeding, communicating, and breathing. Human patients with sleep apnea have enlarged tongues, characterized by reduced muscle tone and increased intramuscular fat that can be visualized and quantified by magnetic resonance imaging (MRI)...
July 6, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28615341/high-frequency-epidural-stimulation-across-the-respiratory-cycle-evokes-phrenic-short-term-potentiation-after-incomplete-cervical-spinal-cord-injury
#7
Elisa J Gonzalez-Rothi, Kristi A Streeter, Marie H Hanna, Anna C Stamas, Paul J Reier, David M Baekey, David D Fuller
C2 spinal hemilesion (C2Hx) paralyzes the ipsilateral diaphragm, but recovery is possible through activation of "crossed spinal" synaptic inputs to ipsilateral phrenic motoneurons. We tested the hypothesis that high frequency epidural stimulation (HF-ES) would potentiate ipsilateral phrenic output after subacute and chronic C2Hx. HF-ES (300 Hz) was applied to the ventrolateral C4 or T2 spinal cord ipsilateral to C2Hx in anesthetized and mechanically ventilated adult rats. Stimulus duration was 60-sec and currents ranged from 100-1000 µA...
June 14, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28561345/outcome-after-one-year-of-upper-airway-stimulation-for-obstructive-sleep-apnea-in-a-multicenter-german-post-market-study
#8
Armin Steffen, J Ulrich Sommer, Benedikt Hofauer, Joachim T Maurer, Katrin Hasselbacher, Clemens Heiser
OBJECTIVE/HYPOTHESIS: Upper airway stimulation (UAS) of the hypoglossal nerve has been implemented in the routine clinical practice for patients with moderate-to-severe obstructive sleep apnea (OSA) who could not adhere to continuous positive airway pressure. This study reports objective and patient-reported outcome after 12 months of implantation. STUDY DESIGN: Multicenter prospective single-arm study. METHODS: Consecutive patients who received the UAS system (Inspire Medical Systems, Inc...
May 31, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28535072/hyoid-arch-displacement-with-hypoglossal-nerve-stimulation
#9
Tarek ElShebiny, Divya Venkat, Kingman Strohl, Mark G Hans, Aurelio Alonso, Juan Martin Palomo
No abstract text is available yet for this article.
May 23, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28477347/p4-medicine-approach-to-obstructive-sleep-apnoea
#10
REVIEW
Diane C Lim, Kate Sutherland, Peter A Cistulli, Allan I Pack
P4 medicine is an evolving approach to personalized medicine. The four Ps offer a means to: Predict who will develop disease and co-morbidities; Prevent rather than react to disease; Personalize diagnosis and treatment; have patients Participate in their own care. P4 medicine is very applicable to obstructive sleep apnoea (OSA) because each OSA patient has a different pathway to disease and its consequences. OSA has both structural and physiological mechanisms with different clinical subgroups, different molecular profiles and different consequences...
July 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28419805/hypoglossal-nerve-upper-airway-stimulator-implantation-after-radiotherapy-for-head-and-neck-malignancy
#11
Zhong Zheng, Shirley Hu, Boris Chernobilsky
No abstract text is available yet for this article.
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28378061/tongue-surgeries-for-pediatric-obstructive-sleep-apnea-a-systematic-review-and-meta-analysis
#12
REVIEW
Macario Camacho, Michael W Noller, Soroush Zaghi, Lauren K Reckley, Camilo Fernandez-Salvador, Erika Ho, Brandyn Dunn, Dylan Chan
OBJECTIVES: To evaluate the international literature for studies reporting outcomes for obstructive sleep apnea (OSA) in children undergoing isolated tongue surgeries. METHODS: Two authors searched from inception through November 14, 2016 in four databases including PubMed/MEDLINE. RESULTS: 351 studies were screened. Eleven studies (116 children) met criteria. Most children were syndromic and had craniofacial disorders, co-morbidities, or other serious medical issues...
August 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28323640/a-micro-scale-printable-nanoclip-for-electrical-stimulation-and-recording-in-small-nerves
#13
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...
June 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
#14
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
#15
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...
April 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28105667/palatoglossus-coupling-in-selective-upper-airway-stimulation
#16
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
#17
MULTICENTER STUDY
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
#18
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...
May 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/27829262/-upper-airway-stimulation-in-osa
#19
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
#20
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
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