Hypoglossal Nerve Stimulator Implantation in an Adolescent With Down Syndrome and Sleep Apnea
| Autor: | Ellen Grealish, John M. Dobrowski, Donald G. Keamy, Brian G. Skotko, Gillian R. Diercks, Ryan J. Soose, Allison Schwartz, Thomas B. Kinane, Christopher J. Hartnick |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Hypoglossal Nerve Adolescent medicine.medical_treatment Electric Stimulation Therapy 03 medical and health sciences 0302 clinical medicine Tracheotomy Tongue medicine Humans Continuous positive airway pressure 030223 otorhinolaryngology Sleep Apnea Obstructive business.industry Sleep apnea Airway obstruction medicine.disease respiratory tract diseases Electrodes Implanted Obstructive sleep apnea medicine.anatomical_structure Apnea–hypopnea index Anesthesia Pediatrics Perinatology and Child Health Down Syndrome business Hypoglossal nerve 030217 neurology & neurosurgery |
| Zdroj: | Pediatrics. 137(5) |
| ISSN: | 1098-4275 |
| Popis: | Obstructive sleep apnea (OSA) is more common in children with Down syndrome, affecting up to 60% of patients, and may persist in up to 50% of patients after adenotonsillectomy. These children with persistent moderate to severe OSA require continuous positive airway pressure, which is often poorly tolerated, or even tracheotomy for severe cases. The hypoglossal nerve stimulator is an implantable device that produces an electrical impulse to the anterior branches of the hypoglossal nerve, resulting in tongue protrusion in response to respiratory variation. It is an effective treatment of sleep apnea in select adult patients because it allows for alleviation of tongue base collapse, improving airway obstruction. Herein we describe the first pediatric hypoglossal nerve stimulator implantation, which was performed in an adolescent with Down syndrome and refractory severe OSA (apnea hypopnea index [AHI]: 48.5 events/hour). The patient would not tolerate continuous positive airway pressure and required a long-standing tracheotomy. Hypoglossal nerve stimulator therapy was well tolerated and effective, resulting in significant improvement in the patient’s OSA (overall AHI: 3.4 events/hour; AHI: 2.5–9.7 events/hour at optimal voltage settings depending on sleep stage and body position). Five months after implantation, the patient’s tracheotomy was successfully removed and he continues to do well with nightly therapy. |
| Databáze: | OpenAIRE |
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