Clemens Heiser1, Günther Edenharter2, Murat Bas1, Markus Wirth1, Benedikt Hofauer1. 1. Department of Otorhinolaryngology-Head and Neck Surgery, Technical University of Munich, Munich, Germany. 2. Department of Anesthesiology, Rechts der Isar Hospital, Technical University of Munich, Munich, Germany.
Abstract
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. A drug-induced sedated endoscopy (DISE) was performed before surgery. Six to 12 months after activation of the system, patients' tongue motions were recorded, an awake transnasal endoscopy was performed with stimulation turned on, and a DISE with stimulation off and on was done. RESULTS: Patients with a bilateral protrusion of the tongue base showed a significantly increased opening at the retropalatal level compared to ipsilateral protrusions. Furthermore, patients with a clear activation of the geniohyoid muscle showed a better reduction in apnea-hypopnea index. CONCLUSIONS: A bilateral protrusion of the tongue base during sUAS seems to be accompanied with a better opening of the soft palate. This effect can be explained by the palatoglossal coupling, due to its linkage of the muscles within the soft palate to those of the lateral tongue body. LEVEL OF EVIDENCE: 4 Laryngoscope, 127:E378-E383, 2017.
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. A drug-induced sedated endoscopy (DISE) was performed before surgery. Six to 12 months after activation of the system, patients' tongue motions were recorded, an awake transnasal endoscopy was performed with stimulation turned on, and a DISE with stimulation off and on was done. RESULTS:Patients with a bilateral protrusion of the tongue base showed a significantly increased opening at the retropalatal level compared to ipsilateral protrusions. Furthermore, patients with a clear activation of the geniohyoid muscle showed a better reduction in apnea-hypopnea index. CONCLUSIONS: A bilateral protrusion of the tongue base during sUAS seems to be accompanied with a better opening of the soft palate. This effect can be explained by the palatoglossal coupling, due to its linkage of the muscles within the soft palate to those of the lateral tongue body. LEVEL OF EVIDENCE: 4 Laryngoscope, 127:E378-E383, 2017.
Authors: Sara Op de Beeck; Marijke Dieltjens; Annelies E Verbruggen; Anneclaire V Vroegop; Kristien Wouters; Evert Hamans; Marc Willemen; Johan Verbraecken; Wilfried A De Backer; Paul H Van de Heyning; Marc J Braem; Olivier M Vanderveken Journal: J Clin Sleep Med Date: 2019-08-15 Impact factor: 4.062
Authors: Markus Wirth; Daniel Unterhuber; Franziska von Meyer; Benedikt Hofauer; Armin Ott; Guenther Edenharter; Danny J Eckert; Clemens Heiser Journal: J Clin Sleep Med Date: 2020-01-13 Impact factor: 4.062
Authors: Eli Van de Perck; Sara Op de Beeck; Marijke Dieltjens; Anneclaire V Vroegop; Annelies E Verbruggen; Marc Willemen; Johan Verbraecken; Paul H Van de Heyning; Marc J Braem; Olivier M Vanderveken Journal: J Clin Sleep Med Date: 2020-07-15 Impact factor: 4.062