Magnetic stimulation of the hypoglossal nerve as a potential outcome predictor before hypoglossal-nerve-stimulator implantation in CPAP non-compliant patients

Background 

Implantation of hypoglossal nerve stimulators is a suitable therapeutic instrument in patients with CPAP-incompliant obstructive sleep apnea syndrome. Currently there are no prognosticators available predicting the outcome of the surgical procedure, i.e. the opening of the deep pharyngeal space.

Patients and Methods 

Transcranial and peripheral magnetic hypoglossal nerve stimulation was performed prospectively in patients during drug induced sleep endoscopy (DISE). The glossopharyngeal as well as the velopharyngeal reactions were video recorded and evaluated prior to an hypoglossal-nerve stimulator implantation.

Results 

In this pilot-study results of the transcranial and peripheral magnetic hypoglossal nerve stimulation are reported. The results, i.e. epiglottic elevation and retraction of the lateral pharyngeal wall, were compared to the DISE results and were regarded as a predictor for the opening of the posterior airway space. The results were grouped and a graduation scale was developed.

Discussion 

Both, transcranial and peripheral magnetic hypoglossal nerve stimulation during MISE is suitable to recognize tongue- and pharyngeal reactions which can be a predictor for the effectiveness of a hypoglossal nerve stimulator implantation. In a next step these preoperative results will be correlated to the postoperative findings in a prospective setting.

Conflict of Interest Der Erstautor weist auf folgenden Interessenkonflikt hin Der Erstautor erhielt einmalig Reisekostenerstattung im Rahmen eines OP-Kurses der Fa. Inspire medical.

Publication History

Article published online:
24 May 2022