Origins of and implementation concepts for upper airway stimulation therapy for obstructive sleep apnea

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• 作者：Kingman P. Strohl ; M.D.^a ; ^{kpstrohl@aol.com" class="auth_mail" title="E-mail the corresponding author} ; Jonathan Baskin ; M.D.^a ; ^{Jonathan.Baskin2@uhhospitals.org" class="auth_mail" title="E-mail the corresponding author} ; Colleen Lance ; M.D.^a ; ^{Colleen.Lance@uhhospitals.org" class="auth_mail" title="E-mail the corresponding author} ; Diana Ponsky ; M.D.^a ; ^{Diana.Ponsky@uhhospitals.org" class="auth_mail" title="E-mail the corresponding author} ; Mark Weidenbecher ; M.D.^a ; ^{Mark.Weidenbecher@uhhospitals.org" class="auth_mail" title="E-mail the corresponding author} ; Madeleine Strohl ; B.A.^b ; ^{madeleinestrohl@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Motoo Yamauchi ; M.D.^c ; ^{mountain@pastel.ocn.ne.jp" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Sleep apnea ; Neurotherapeutics ; Hypoglossal nerve ; Pharynx ; Genioglossus
• 刊名：Respiratory Investigation
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：54
• 期：4
• 页码：241-249
• 全文大小：1204 K

文摘

Upper airway stimulation, specifically hypoglossal (CN XII) nerve stimulation, is a new, alternative therapy for patients with obstructive sleep apnea hypopnea syndrome who cannot tolerate positive airway pressure, the first-line therapy for symptomatic patients. Stimulation therapy addresses the cause of inadequate upper airway muscle activation for nasopharyngeal and oropharyngeal airway collapse during sleep. The purpose of this report is to outline the development of this first-in-class therapy and its clinical implementation. Another practical theme is assessment of the features for considering a surgically implanted device and the insight as to how both clinical and endoscopic criteria increase the likelihood of safe and durable outcomes for an implant and how to more generally plan for management of CPAP-intolerant patients. A third theme is the team building required among sleep medicine and surgical specialties in the provision of individualized neurostimulation therapy.