Hypoglossal Nerve Monitoring During Sleep Surgery: Methodology, Utility Optimization
| Autor: | Joshua J. Sturm, Maria V. Suurna |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Sleep surgery
business.industry Stimulation medicine.disease Hypoglossal nerve fibers Obstructive sleep apnea 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Otorhinolaryngology Tongue 030220 oncology & carcinogenesis Anesthesia Cuff medicine Immunology and Allergy Surgery Neurology (clinical) Tongue protrusion 030223 otorhinolaryngology business Hypoglossal nerve |
| Zdroj: | Current Otorhinolaryngology Reports. 9:304-308 |
| ISSN: | 2167-583X |
| DOI: | 10.1007/s40136-021-00350-w |
| Popis: | The effectiveness of hypoglossal nerve stimulation (HGNS) in the treatment of obstructive sleep apnea (OSA) depends upon selective stimulation of nerve fibers that innervate muscles that produce tongue protrusion and stiffening, without activating those that innervate muscles that produce tongue retraction. This selective stimulation can be optimized by use of intraoperative hypoglossal nerve stimulation and monitoring during stimulator implantation. This article describes the methodology for applying nerve monitoring during HGNS surgery and reviews evidence supporting its utility in optimizing therapeutic outcomes. Intraoperative nerve stimulation and monitoring can successfully and reliably isolate hypoglossal nerve fibers that innervate muscles that produce tongue protrusion (to be included within the implanted electrode cuff) from those that innervate muscles that produce retraction (to be excluded from the cuff). This minimizes post-implantation mixed activation (both tongue protrusion and retraction), which can inhibit therapeutic responses to HGNS. The efficacy of HGNS in the treatment of OSA can be optimized by using intraoperative nerve stimulation and monitoring. |
| Databáze: | OpenAIRE |
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