Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea and Comorbid Neuromuscular Disorders

IF 2 3区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Laryngoscope Pub Date : 2025-02-15 DOI:10.1002/lary.32050

Alison Y. Choi BS, Thomas M. Kaffenberger MD, Ryan J. Soose MD, Rachel L. Whelan MD

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Abstract

Hypoglossal nerve stimulation (HGNS) is an effective surgical treatment for many patients with moderate-to-severe obstructive sleep apnea (OSA) who are unable to tolerate continuous positive airway pressure. Patients with neuromuscular disorders (NMD) are particularly vulnerable to more complex sleep-related breathing disorders due to respiratory muscle weakness and the associated risk of hypoventilation.

In this study, we present five patients with myasthenia gravis (n = 2), muscular dystrophy, Charcot-Marie-Tooth, and advanced multiple sclerosis who underwent HGNS therapy for OSA.

At time of surgery, the mean patient age was 54 ± 18.7 years and mean BMI was 24.6 ± 4.6 kg/m². Mean device adherence was 8 ± 1.1 h/night at three months and 7.2 ± 1.7 h/night at 12 months. Mean apnea-hypopnea index (AHI) improved significantly from preoperative baseline (34.9 to 8.5, p = 0.03) and 5/6 patients had a postoperative AHI <5. Epworth Sleepiness Scale scores significantly improved postoperatively (13.1–8.5, p = 0.03). Oxygen nadir trended upward (75.5–85.3, p = 0.84).

Our limited findings demonstrate that HGNS was a safe and effective treatment for five patients with OSA and comorbid NMD. Prospective studies and larger sample sizes are warranted to support our findings and confirm whether HGNS is a potential therapeutic option for this unique patient population. Laryngoscope, 135:2631–2633, 2025

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舌下神经刺激治疗阻塞性睡眠呼吸暂停和共病性神经肌肉疾病。

舌下神经刺激（HGNS）是许多无法忍受持续气道正压的中重度阻塞性睡眠呼吸暂停（OSA）患者的有效手术治疗方法。神经肌肉疾病（NMD）患者由于呼吸肌肉无力和相关的低通气风险，特别容易出现更复杂的睡眠相关呼吸障碍。在这项研究中，我们报告了5例重症肌无力（n = 2）、肌肉萎缩症、沙克-玛丽-图斯症和晚期多发性硬化症患者，他们接受了HGNS治疗OSA。手术时患者平均年龄54±18.7岁，平均BMI为24.6±4.6 kg/m2。3个月时器械的平均依从性为8±1.1 h/晚，12个月时为7.2±1.7 h/晚。平均呼吸暂停低通气指数（AHI）较术前基线显著改善（34.9至8.5,p = 0.03）， 5/6患者术后有AHI

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来源期刊

Laryngoscope 医学-耳鼻喉科学

CiteScore

6.50

自引率

7.70%

发文量

500

审稿时长

2-4 weeks

期刊介绍： The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope. • Broncho-esophagology • Communicative disorders • Head and neck surgery • Plastic and reconstructive facial surgery • Oncology • Speech and hearing defects