Journal
LARYNGOSCOPE
Volume 126, Issue 12, Pages 2852-2858Publisher
WILEY-BLACKWELL
DOI: 10.1002/lary.26026
Keywords
Selective upper-airway stimulation; obstructive sleep apnea; NIM; nerve integrity monitoring system; hypoglossal nerve
Funding
- Inspire Medical Systems (Maple Grove, MN)
- Inspire Medical Systems
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Objective/HypothesisSelective 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 DesignSingle-center, prospective clinical trial. MethodsTwenty 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. ResultsAll 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. ConclusionThis 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 Evidence4. Laryngoscope, 126:2852-2858, 2016
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