Could a selective nerve integrity monitoring (NIM) system aid in placement of the cuff electrode in selective upper-airway stimulation?
Selective nerve monitoring is able to identify the protruding and stiffening fibers of the hypoglossal nerve, and therefore facilitates the precise inclusion and exclusion of nerve fibers during intraoperative placement of the stimulation cuff electrode.
Explore this issue:December 2016
Background: Unilateral therapeutic electrical stimulation of the hypoglossal nerve is feasible and a potential therapeutic option for obtructive sleep apnea. The desired target for success therefore seems to be the selective stimulation of the hypoglossal nerve fibers, which are responsible for the protrusors and stiffeners while excluding the retractors, thereby achieving unhindered protrusion of a stiffened tongue. The postoperative tongue motions in upper airway stimulation are associated with therapy outcome. The stimulation cuff electrode placement on the hypoglossal nerve for selective muscle recruitment seems to play an important role in the mechanism of action. The aim of this study was to investigate whether intraoperative selective nerve monitoring can reliably identify the protruding and stiffening fibers of the hypoglossal nerve to facilitate precise placement of the stimulating cuff electrode.
Study design: Single-center, prospective clinical trial.