Surface electromyography (EMG s) is a noninvasive method to detect and record electric potentials from voluntary muscles. However, the success rate among patients meeting criteria for HGNS therapy (60–70%) suggests the need for further understanding about this therapy. Ultimately, OSA severity defined as Apnea–Hypopnea Index (AHI) > 65, body mass index (BMI) > 35, and complete circumferential pattern of collapse during drug-induced sleep endoscopy (DISE) were considered exclusion criteria for HGNS implantation. There are currently several types of devices differing regarding implantation site and stimulation mode. In the past three decades, several studies have demonstrated HGNS to be a safe and effective treatment for patients with OSA not adherent to positive airway pressure (PAP) therapy.
Hypoglossal nerve stimulation (HGNS) can increase genioglossus muscle activity and effectively prevent pharyngeal collapse during sleep in patients with obstructive sleep apnea (OSA). This data provides new insights on how stimulation of the hypoglossal nerve trunk may contribute to obstructive sleep apnea treatment. Conclusionīeyond the genioglossus muscle, our findings demonstrate recruitment of other muscles during hypoglossal nerve stimulation, which may be attributed to the electrical stimulation of the nerve trunk. The masseters also presented a considerable asymmetry in electrical potential on the right side (> 55%). The same channels also significantly increased the electrical activity on suprahyoid muscles bilaterally, but predominantly on the stimulated side (right). Activation of electrodes 2, 3, and 6 promoted upper airway opening most strongly at the velopharynx and tongue base during drug-induced sleep endoscopy. Concurrent surface electromyography of the suprahyoid muscles and masseter was obtained. However, due to snoring complaints, he underwent postoperation drug-induced sleep endoscopy for evaluation of electrode activation during upper airway collapse, aiming to improve electrostimulation parameters. Case presentationĪ 48-year-old Caucasian male patient with obstructive sleep apnea had been successfully treated with electrical stimulation of the hypoglossal nerve trunk, documented by level 1 polysomnography data. However, the recommended criteria for patient selection are still unable to identify all the unresponsive patients, highlighting the need for improved understanding about hypoglossal nerve stimulation for obstructive sleep apnea. Literature has demonstrated hypoglossal nerve stimulation to be a safe and effective treatment for patients with obstructive sleep apnea nonadherent to positive airway pressure therapy.
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