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Hypoglossal nerve stimulation

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https://www.readbyqxmd.com/read/29703415/electroconvulsive-therapy-for-depression-in-a-patient-with-an-inspire-hypoglossal-nerve-stimulator-device-for-obstructive-sleep-apnea-a-case-report
#1
Katie Mingo, Alan Kominsky
OUTCOME OBJECTIVES: METHODS: This is a case report of a patient who underwent placement and initiation of a hypoglossal nerve stimulator device in the context of receiving electroconvulsive therapy for bipolar depression between February and September 2016. To our knowledge, this has not yet been reported in the literature. Outcome measurements included successful device activation and successful device use throughout electroconvulsive therapy. RESULTS: The patient underwent successful device implantation, activation, and use without disruption throughout electroconvulsive therapy sessions...
April 19, 2018: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/29678782/early-feasibility-of-hypoglossal-nerve-upper-airway-stimulator-in-patients-with-cardiac-implantable-electronic-devices-and-continuous-positive-airway-pressure-intolerant-severe-obstructive-sleep-apnea
#2
Valay Parikh, Erica Thaler, Masanari Kato, M Boyd Gillespie, Shaun Nguyen, Kirk Withrow, David Calhoun, Ryan Soose, Damien Stevens, Suzanne Stevens, Chris Larsen, Madhu Reddy, Dhanunjaya Lakkireddy
BACKGROUND: Implantable hypoglossal nerve upper airway stimulation (HNS) is a novel, FDA approved strategy for management of moderate to severe obstructive sleep apnea(OSA) patients with continuous positive airway pressure (CPAP) therapy intolerance or failure. Due to proximity of Cardiac Implantable Electronic Devices (CIED) and this stimulator, interaction between these devices is theoretically possible. OBJECTIVE: The purpose of this study was to assess interactions between implantable hypoglossal nerve upper airway stimulator device and cardiac implantable electronic devices...
April 17, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29592978/hypoglossal-nerve-stimulation-for-obstructive-sleep-apnoea-in-a-patient-with-previous-tongue-laceration
#3
Joel W Jones, Kent Lee, Suzanne Stevens, Chris Larsen
Upper airway stimulation of the tongue using an implantable neurostimulator has recently been approved for select patients with moderate to severe obstructive sleep apnoea (OSA) and intolerance to continuous positive airway pressure therapy. Effective implantation depends on the integrity of the hypoglossal nerve as well as the tongue musculature, notably the genioglossus. Prior trauma to either of these structures may be viewed as a relative contraindication to implantation. We describe a case of successful right hypoglossal nerve implantation in a patient with a history of left cardiac pacemaker placement and severe left penetrating tongue trauma with decreased mobility from contracture and deviation mimicking a hypoglossal nerve palsy...
March 28, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29590480/anatomic-predictors-of-response-and-mechanism-of-action-of-upper-airway-stimulation-therapy-in-patients-with-obstructive-sleep-apnea
#4
Richard J Schwab, Stephen H Wang, Johan Verbraecken, Olivier M Vanderveken, Paul Van de Heyning, Wim G Vos, Jan W DeBacker, Brendan T Keenan, Quan Ni, Wilfried DeBacker
Study Objectives: Upper airway stimulation has been shown to be an effective treatment for some patients with obstructive sleep apnea. However, the mechanism by which hypoglossal nerve stimulation increases upper airway caliber is not clear. Therefore, the objective of this study was to identify the mechanism of action of upper airway stimulation. We hypothesized that, with upper airway stimulation, responders would show greater airway opening in the retroglossal (base of the tongue) region, greater hyoid movement toward the mandible, and greater anterior motion in the posterior, inferior region of the tongue compared with nonresponders...
April 1, 2018: Sleep
https://www.readbyqxmd.com/read/29582703/upper-airway-stimulation-for-obstructive-sleep-apnea-5-year-outcomes
#5
B Tucker Woodson, Kingman P Strohl, Ryan J Soose, M Boyd Gillespie, Joachim T Maurer, Nico de Vries, Tapan A Padhya, M Safwan Badr, Ho-Sheng Lin, Olivier M Vanderveken, Sam Mickelson, Patrick J Strollo
Objective To present 5-year outcomes from a prospective cohort of patients with obstructive sleep apnea (OSA) who were treated with upper airway stimulation (UAS) via a unilateral hypoglossal nerve implant. Study Design A multicenter prospective cohort study. Setting Industry-supported multicenter academic and clinical trial. Methods From a cohort of 126 patients, 97 completed protocol, and 71 consented to a voluntary polysomnogram. Those having continuous positive airway pressure failure with moderate to severe OSA, body mass index <32 kg/m2 , and no unfavorable collapse on drug-induced sleep endoscopy were enrolled in a phase 3 trial...
March 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29540289/uvulopalatopharyngoplasty-vs-cn-xii-stimulation-for-treatment-of-obstructive-sleep-apnea-a-single-institution-experience
#6
Janki Shah, Jonathon O Russell, Tina Waters, Alan H Kominsky, Douglas Trask
OBJECTIVES: Hypoglossal nerve stimulation (HNS) therapy is an emerging surgical treatment for select patients with obstructive sleep apnea (OSA). This study aims to compare outcomes in patients with moderate to severe OSA who underwent HNS surgery (Inspire Medical Systems) and those who underwent traditional airway reconstructive surgery, specifically uvulopalatopharyngoplasty (UPPP). METHODS: Patients who underwent HNS implantation (n = 20), all with moderate to severe OSA, inability to adhere to positive pressure therapy, and compliant with previously published inclusion criteria, were compared to a historical cohort that were intolerant of CPAP with similar inclusion criteria who all underwent UPPP (n = 20) with some also undergoing additional procedures such as septoplasty/turbinate reduction...
May 2018: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/29501517/intraoperative-hypoglossal-nerve-mapping-during-carotid-endarterectomy-technical-note
#7
Atsuhiro Kojima, Isako Saga, Mami Ishikawa
BACKGROUND: Hypoglossal nerve deficit is a possible complication caused by carotid endarterectomy (CEA). The accidental injury of the hypoglossal nerve during surgery is one of the major reasons for permanent hypoglossal nerve palsy. In this study, we investigated the usefulness of intraoperative mapping of the hypoglossal nerve to identify this nerve during CEA. METHODS: Five consecutive patients who underwent CEA for the treatment of symptomatic or asymptomatic carotid artery stenosis were studied...
May 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29410358/hypoglossal-nerve-stimulation-in-a-pre-clinical-anesthetized-rabbit-model-relevant-to-osa
#8
Girriso F Benderro, Jenniffer Gamble, Matthew A Schiefer, Jonathan Z Baskin, Yeritza Hernandez, Kingman P Strohl
We tested the functional effects of hypoglossal (CNXII) stimulation in the anesthetized rabbit before and after injections of saline into the tongue base to obstruct the airway. Data (n = 6) show little or no effect of CN XII trunk stimulation; however, medial branch stimulation (20-100 Hz; 50-500 μs pulse width, and incremental increases from 10 μA) reduced upper airway resistance. Medial branch stimulation was less effective in reducing resistance than anterior advancement of the hyoid. Endoscopic viewing (n-3) of the retropalate showed this region as the narrowest and dynamically changed by anterior hyoid displacement, with less evident effects than CNXII stimulation...
April 2018: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/29357492/involvement-of-hypoglossal-and-recurrent-laryngeal-nerves-on-swallowing-pressure
#9
Takanori Tsujimura, Taku Suzuki, Midori Yoshihara, Shogo Sakai, Naomi Koshi, Hirokazu Ashiga, Naru Shiraishi, Kojun Tsuji, Jin Magara, Makoto Inoue
Swallowing pressure generation is important to ensure safe transport of an ingested bolus without aspiration or leaving residue in the pharynx. To clarify the mechanism, we measured swallowing pressure at the oropharynx (OP), upper esophageal sphincter (UES), and cervical esophagus (CE) using a specially designed manometric catheter in anesthetized rats. A swallow-evoked by punctate mechanical stimulation to the larynx-was identified by recording activation of the suprahyoid and thyrohyoid muscles using electromyography (EMG)...
January 4, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29280488/tongue-motion-variability-with-changes-of-upper-airway-stimulation-electrode-configuration-and-effects-on-treatment-outcomes
#10
Armin Steffen, Ayse Kilic, Inke R König, Maria V Suurna, Benedikt Hofauer, Clemens Heiser
OBJECTIVES/HYPOTHESIS: Upper airway stimulation (UAS) is an effective treatment for obstructive sleep apnea (OSA). Previous data have demonstrated a correlation between the phenotype of tongue motion and therapy response. Closed loop hypoglossal nerve stimulation implant offers five different electrode configuration settings which may result in different tongue motion. STUDY DESIGN: Two-center, prospective consecutive trial in a university hospital setting. METHODS: Clinical outcomes of 35 patients were analyzed after at least 12 months of device use...
December 27, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29277289/voice-and-swallowing-outcomes-following-hypoglossal-nerve-stimulation-for-obstructive-sleep-apnea
#11
Andrew J Bowen, Amy S Nowacki, Alan H Kominsky, Douglas K Trask, Michael S Benninger, Paul C Bryson
OBJECTIVE: Hypoglossal nerve stimulation is an effective treatment for a subset of patients with Obstructive Sleep Apnea (OSA). Although multiple clinical trials demonstrate its efficacy, no previous literature explores the potential impact the stimulator has on swallowing and voice. Our primary objective is to evaluate patient reported post-operative changes in voice or swallowing following hypoglossal nerve stimulator placement. STUDY DESIGN: Prospective cohort study...
March 2018: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/29276665/insights-since-fda-approval-of-hypoglossal-nerve-stimulation-for-the-treatment-of-obstructive-sleep-apnea
#12
Madeleine M Strohl, Motoo Yamauchi, Zhe Peng, Kingman P Strohl
Purpose: The literature on hypoglossal nerve stimulation (HNS) for the treatment of moderate-to-severe obstructive sleep apnea (OSA) was reviewed from 2014, the time of FDA approval for the Inspire Systems device, to 2017 for themes that might be useful conceptually and practically in the consideration of this new non-anatomic surgical therapy. Recent Findings: there are now further follow-up articles since the 12-month results for Apnea Reduction (STAR) trial of the Inspire device, and post-approval publications which report similar and/0r improved AHI outcomes...
September 2017: Current Sleep Medicine Reports
https://www.readbyqxmd.com/read/29214634/a-case-of-hypoglossal-nerve-stimulator-resistant-obstructive-sleep-apnea-cured-with-the-addition-of-a-chin-strap
#13
Apoorva T Ramaswamy, Carol Li, Maria V Suurna
A population of appropriately selected patients does not respond, or does not achieve cure, with hypoglossal nerve stimulation (HGNS). We describe the case of nonresponder whose obstructive sleep apnea (OSA) resolved with the addition of chin strap. After initial placement and titration of HGNS implant, follow-up sleep study demonstrated persistent moderate OSA. Drug-induced sleep endoscopy demonstrated supraglottic collapse with activate neurostimulation. With mouth closure and change of stimulation settings to unipolar from bipolar, the airway collapse and desaturations improved...
December 7, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29206695/drug-induced-sleep-endoscopy-from-obscure-technique-to-diagnostic-tool-for-assessment-of-obstructive-sleep-apnea-for-surgical-interventions
#14
Joshua H Atkins, Jeff E Mandel
PURPOSE OF REVIEW: Provide a practical update on drug-induced sleep endoscopy (DISE) for anesthesia providers, which can also serve as a reference for those preparing to establish a DISE program. RECENT FINDINGS: New developments in surgical approaches to OSA and the growing global incidence of the condition have stimulated increased interest and demand for drug-induced sleep endoscopy. New techniques include transoral robotic surgery and hypoglossal nerve stimulation...
February 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29204583/osa-treatment-history-in-an-upper-airway-stimulation-trial-cohort
#15
Ryan J Soose, Tapan A Padhya, M Boyd Gillespie, Oleg Froymovich, Ho-Sheng Lin, B Tucker Woodson
Objectives: Analyze the obstructive sleep apnea (OSA) treatment history in a group of participants who enrolled in a hypoglossal nerve stimulation trial. Methods: Moderate-severe OSA patients with difficulty adhering to CPAP presented for enrollment in a multicenter trial. Self-reported history on prior OSA medical therapy was collected at enrollment, including OSA diagnosis date, CPAP start and stop dates, oral appliance trial, and reasons for discontinuation or non-adherence...
June 2017: World journal of otorhinolaryngology—head and neck surgery
https://www.readbyqxmd.com/read/29153261/improving-surgical-results-in-complex-nerve-anatomy-during-implantation-of-selective-upper-airway-stimulation
#16
Zhaojun Zhu, Benedikt Hofauer, Clemens Heiser
The following report presents a case of two late embedded hypoglossus branches during implantation of an upper airway stimulation device that caused a mixed activation of the tongue when included in the stimulation cuff. In the end, correct cuff placement could be achieved by careful examination of the hypoglossal nerve anatomy, precise nerve dissection, tongue motion analysis and intraoperative nerve monitoring.
November 15, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/29098288/hypoglossal-nerve-stimulation-in-adolescents-with-down-syndrome-and-obstructive-sleep-apnea
#17
Gillian R Diercks, Carissa Wentland, Donald Keamy, Thomas Bernard Kinane, Brian Skotko, Vanessa de Guzman, Ellen Grealish, John Dobrowski, Ryan Soose, Christopher J Hartnick
Importance: Obstructive sleep apnea (OSA) affects up to 60% of children with Down syndrome (DS) and may persist in half of patients after adenotonsillectomy. Children with DS who have persistent OSA often do not tolerate treatment with positive pressure airway support devices or tracheotomy for their residual moderate to severe OSA. The hypoglossal nerve stimulator is an implantable device that delivers an electrical impulse to anterior branches of the hypoglossal nerve in response to respiratory variation, resulting in tongue base protrusion that alleviates upper airway obstruction in adults...
November 2, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29050104/-hypoglossal-nerve-stimulation-therapy-for-obstructive-sleep-apnea-hypopnea-syndrome
#18
Q Yan, B Guan
Obstructive sleep apnea hypopnea syndrome(OSAHS) is a clinical and critical disease to health, which the accuratly pathogenesis is not very explicit. The mainstream research suggested that dysfunction of upper airway dilator muscles is one of the hazard factors. Genioglossus innervated by the hypoglossal nerve plays crucial roles. It could expand volume of pharyngeal cavity, and increase airflow rate when stimulate it.With the development of anatomy and physiology, hypoglossal nerve stimulation(HGNS) entered into clinical trials, and had made tremendous progress since 2001...
October 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/29018786/hypoglossal-nerve-stimulation-for-treatment-of-obstructive-sleep-apnea-osa-a-primer-for-oral-and-maxillofacial-surgeons
#19
REVIEW
Sung Ok Hong, Yu-Feng Chen, Junho Jung, Yong-Dae Kwon, Stanley Yung Chuan Liu
The prevalence of obstructive sleep apnea (OSA) is estimated to be 1-5% of the adult population world-wide, and in Korea, it is reported at 4.5% of men and 3.2% of women (Age 40 to 69 years old). Active treatment of OSA is associated with decrease in insulin resistance, cardiovascular disease, psychosocial problems, and mortality. Surgical treatment of OSA has evolved in the era of neuromodulation with the advent of hypoglossal nerve stimulation (HGNS). We share this review of HGNS with our maxillofacial surgical colleagues to expand the scope of surgical care for OSA...
December 2017: Maxillofacial Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28983236/development-of-a-clinical-pathway-and-technical-aspects-of-upper-airway-stimulation-therapy-for-obstructive-sleep-apnea
#20
REVIEW
Olivier M Vanderveken, Jolien Beyers, Sara Op de Beeck, Marijke Dieltjens, Marc Willemen, Johan A Verbraecken, Wilfried A De Backer, Paul H Van de Heyning
Obstructive sleep apnea (OSA) is a common disease with high morbidity and related mortality. Narrowing and collapse of the pharyngeal airway during sleep characterize the disease, resulting in a decrease (hypopnea) or a complete cessation (apnea) of oronasal airflow. Upper airway stimulation (UAS), using electrical neurostimulation of the hypoglossal nerve (n. XII) synchronized with ventilation, is a novel, evolving treatment option. UAS was found to be an effective treatment in CPAP-intolerant patients. The treatment success is partly due to the strict selection of the patients, based on previous findings...
2017: Frontiers in Neuroscience
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