Pediatric Modifications to Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea: How I Do It

Jayawardena, Asitha D L; Randolph, Greg; Hartnick, Christopher J.

doi:10.1002/lary.28661

Cited by 7 publications

(3 citation statements)

References 8 publications

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“…All six published manuscripts to date on the use of HGNS in children have been based off a single ongoing clinical trial (NCT02344108, "A Pilot Study to Evaluate the Hypoglossal Nerve Stimulator in Adolescents with Down Syndrome and Obstructive Sleep Apnea"). Of these six manuscripts, three have focused on hypoglossal nerve stimulator efficacy results [68][69][70], while two discussed the surgical approach to hypoglossal nerve stimulator implantation [71,72] and one reported the anesthesia approach to hypoglossal nerve stimulator implantation [73].…”

Section: Hypoglossal Nerve Stimulation In Childrenmentioning

confidence: 99%

“…Device implantation is similar to that for adults, with slight modifications. In children, only a single incision is used, and a tunneled approach is used to place the implantable pace generator and respiratory sensing lead [71,72]. Additionally, due to smaller patient size and associated decreased amount of space available in the chest, there is a concern about possible cardiac interference with the sensing lead.…”

Section: Pediatric Modifications To Hypoglossal Nerve Stimulator Implmentioning

confidence: 99%

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The Hypoglossal Nerve Stimulation as a Novel Therapy for Treating Obstructive Sleep Apnea—A Literature Review

Mashaqi

Patel

Combs

et al. 2021

IJERPH

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Obstructive sleep apnea (OSA) is a common sleep disorder that affects all age groups and is associated with many co-morbid diseases (especially cardiovascular diseases). Continuous positive airway pressure (CPAP) is the gold standard for treating OSA. However, adherence to PAP therapy has been a major challenge with an estimated adherence between 20 and 80%. Mandibular advancement devices (MAD) are a good alternative option if used in the appropriate patient. MAD are most effective in mild and moderate OSA but not severe OSA. Surgical options are invasive, not appropriate for severe OSA, and associated with pain and long healing time. Hypoglossal nerve stimulation (HGNS), or upper airway stimulation (UAS), is a novel therapy in treating moderate and severe degrees of OSA in patients who cannot tolerate CPAP therapy. We reviewed the MEDLINE (PubMed) database. The search process yielded 303 articles; 31 met the inclusion and exclusion criteria and were included. We concluded that hypoglossal nerve stimulation is a very effective and novel alternative therapy for moderate and severe OSA in patients who cannot tolerate CPAP therapy. Adherence to HGNS is superior to CPAP. However, more developments are needed to ensure the highest safety profile.

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Section: Hypoglossal Nerve Stimulation In Childrenmentioning

confidence: 99%

Section: Pediatric Modifications To Hypoglossal Nerve Stimulator Implmentioning

confidence: 99%

The Hypoglossal Nerve Stimulation as a Novel Therapy for Treating Obstructive Sleep Apnea—A Literature Review

Mashaqi

Patel

Combs

et al. 2021

IJERPH

View full text Add to dashboard Cite

show abstract

“…En una publicación reciente, Jayawardena y cols. 54 analizaron retrospectivamente su experiencia en 23 niños con trisomía 21 en quienes introdujeron modificaciones en la técnica de implantación respecto a los adultos. Ninguno de los pacientes presentó complicaciones mayores cardiopulmonares y concluyeron que los cambios realizados mejoran tanto la seguridad como la eficacia del procedimiento en la población pediátrica.…”

Section: Estimulación Del Nervio Hipoglosounclassified

Síndrome de apnea obstructiva del sueño persistente en niños adenoamigdalectomizados: artículo de revisión

Ringler

Gajardo

2021

Rev. Otorrinolaringol. Cir. Cabeza Cuello

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Optimizing Inspire Hypoglossal Nerve Stimulator Settings in Pediatric Obstructive Sleep Apnea

Marcus,

Larrow,

Gipson

et al. 2024

The Laryngoscope

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IntroductionHypoglossal nerve stimulation (HGNS) is an effective therapy for carefully selected pediatric patients with Down syndrome (DS) and obstructive sleep apnea (OSA), but optimization of device settings has been focused on stimulation settings. The potential benefits of sensing lead setting optimization have not been investigated. We describe a series of three cases of HGNS in children with DS where optimization of both the stimulation lead and sensing lead settings, as well as utilization of drug‐induced sleep endoscopy (DISE), when indicated, was more effective than stimulation lead optimization alone.MethodsUsing our novel titration algorithm, among the three identified pediatric patients with DS in whom HGNS initially failed to reduce the apnea‐hypopnea index (AHI), two patients in whom sleep studies were characterized as hypopnea‐dominant were assigned to advanced titration (optimization of stimulation settings and sensing lead settings). The third patient, with an obstructive apnea‐dominant sleep study, was referred for interrogated DISE. Advanced titration included adjustment of both stimulation settings and sensing lead settings.ResultsApplication of the advanced titration algorithm, tailored to obstructive apnea‐ versus hypopnea‐dominant sleep patterns, resulted in approximately 50% or greater reduction in AHI in all three patients. “Normal to mild OSA” AHI (AHI <5) was achieved in two patients.ConclusionsA novel diagnostic and therapeutic titration algorithm for the Inspire HGNS system significantly reduced AHI in three pediatric patients with DS and OSA who had failed to respond to the standard device titration that focused solely on stimulation settings.Level of Evidence4 Laryngoscope, 2024

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Pediatric Modifications to Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea: How I Do It

Cited by 7 publications

References 8 publications

The Hypoglossal Nerve Stimulation as a Novel Therapy for Treating Obstructive Sleep Apnea—A Literature Review

The Hypoglossal Nerve Stimulation as a Novel Therapy for Treating Obstructive Sleep Apnea—A Literature Review

Síndrome de apnea obstructiva del sueño persistente en niños adenoamigdalectomizados: artículo de revisión

Optimizing Inspire Hypoglossal Nerve Stimulator Settings in Pediatric Obstructive Sleep Apnea

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