International Journal of Head and Neck Surgery

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VOLUME 10 , ISSUE 4 ( October-December, 2019 ) > List of Articles

Special Issue 4: Invited Article

Upper Airway Stimulation in the Management of Obstructive Sleep Apnea Syndrome: Neurostimulation of Hypoglossal Nerve

Peter Baptista, Carlos Prieto, Octavio Garaycochea

Keywords : Continuous positive airway pressure, Functional outcomes of sleep questionnaire, Upper airway stimulation

Citation Information : Baptista P, Prieto C, Garaycochea O. Upper Airway Stimulation in the Management of Obstructive Sleep Apnea Syndrome: Neurostimulation of Hypoglossal Nerve. Int J Head Neck Surg 2019; 10 (4):77-85.

DOI: 10.5005/jp-journals-10001-1381

License: CC BY-NC 4.0

Published Online: 01-12-2019

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Obstructive sleep apnea (OSA) syndrome is one of the most prevalent chronic diseases in the general population. Continuous positive airway pressure (CPAP), is considered the gold standard therapy for its treatment, but adherence is a critical issue that decreases its use. Upper airway stimulation (UAS) through selective hypoglossal nerve stimulation has emerged as a non-anatomically modifying surgery has shown long-term improvements in objective respiratory and subjective quality-of-life outcome measures. It provides multilevel upper airway improvement through its action at the retrolingual and retropalatal portion of the airway, with the advantage of being an adjustable medical device. The two different commercially available implants are Imthera (LivaNova) and Inspire (Inspire Medical Systems). A large amount of information has been described mainly with the Inspire upper airway stimulation system. Patient selection criteria, implantation timeline, the operative procedure with activation and follow-up are discussed. Multiple studies that have shown significant improvements in both subjective and objective outcome measures as apnea hypopnea index (AHI), oxygen desaturation index (ODI), Epworth sleepiness scale (ESS), functional outcomes of sleep questionnaire (FOSQ) have been shown to be maintained respectively at long term follow-up.


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