Universidad Peruana Cayetano Heredia

Ultrasound Localization and Percutaneous Electrical Stimulation of the Hypoglossal Nerve and Ansa Cervicalis

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dc.contributor.author Kent, David T.
dc.contributor.author Schwartz, Alan R.
dc.contributor.author Zealear, David
dc.date.accessioned 2021-04-13T20:51:03Z
dc.date.available 2021-04-13T20:51:03Z
dc.date.issued 2020
dc.identifier.uri https://hdl.handle.net/20.500.12866/9227
dc.description.abstract OBJECTIVE: Hypoglossal nerve stimulation for obstructive sleep apnea (OSA) can be effective for appropriately selected patients, but current patient selection criteria are complex and still result in a proportion of nonresponders. Ansa cervicalis stimulation of the infrahyoid cervical strap muscles has recently been proposed as a new form of respiratory neurostimulation (RNS) therapy for OSA treatment. We hypothesized that percutaneous stimulation of both nerves in humans with temporary electrodes would make testing of the physiologic response to different RNS strategies possible. STUDY DESIGN: Nonrandomized acute physiology study. SETTING: Tertiary care hospital. METHODS: Fifteen participants with OSA underwent ultrasonography and placement of percutaneous electrodes proximal to the medial division of the hypoglossal nerve and the branch of the ansa cervicalis innervating the sternothyroid muscle (AC(ST)). Procedural success was documented in each participant, as were any failures or procedural complication. RESULTS: The hypoglossal nerve was successfully localized in 15 of 15 (100%) participants and successfully stimulated in 13 of 15 (86.7%). The AC(ST) was successfully localized in 15 of 15 (100%) participants and successfully stimulated in 14 of 15 (93.3%). Stimulation failure of the hypoglossal nerve was due to suboptimal electrode placement in 1 participant and electrode displacement in the other 2 cases. No complications occurred. CONCLUSIONS: The hypoglossal nerve and AC(ST) can be safely stimulated via percutaneous electrode placement. Larger trials of percutaneous stimulation may help to identify responders to different RNS therapies for OSA with temporary or permanent percutaneous electrodes. Techniques for electrode design, nerve localization, and electrode placement are described. en_US
dc.language.iso eng
dc.publisher SAGE Publications
dc.relation.ispartofseries Otolaryngology--head and neck surgery
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject ultrasound en_US
dc.subject ansa cervicalis en_US
dc.subject hypoglossal nerve stimulation en_US
dc.subject obstructive sleep apnea en_US
dc.subject respiratory neurostimulation en_US
dc.title Ultrasound Localization and Percutaneous Electrical Stimulation of the Hypoglossal Nerve and Ansa Cervicalis en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1177/0194599820959275
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.11
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.23
dc.relation.issn 1097-6817


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