Cross motor innervation of the hypoglossal nerve—a pilot study of predictors for successful opening of the soft palate
Purpose Selective hypoglossal nerve stimulation has proven to be a successful treatment option in patients with obstructive sleep apnea. The aim of this pilot study was to investigate if there is a cross-innervation of the hypoglossal nerve in humans and if patients with this phenotype show a differ...
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| Veröffentlicht in: | Sleep & breathing 2021-03, Vol.25 (1), p.425-431 |
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| creator | Heiser, Clemens Vanderveken, Olivier M. Edenharter, Günther M. Hofauer, Benedikt |
| description | Purpose
Selective hypoglossal nerve stimulation has proven to be a successful treatment option in patients with obstructive sleep apnea. The aim of this pilot study was to investigate if there is a cross-innervation of the hypoglossal nerve in humans and if patients with this phenotype show a different response to hypoglossal nerve stimulation compared to those with ipsilateral-only innervation
Methods
Nineteen patients who previously received a selective hypoglossal nerve stimulation system (Inspire Medical Systems, Golden Valley, USA) were implanted with a nerve integrity system placing electrodes on both sides of the tongue. Tongue motions were recorded one and two months after surgery from transoral and transnasal views. Polysomnography (PSG) was also performed at two months. Electromyogram (EMG) signals and tongue motions after activation were compared with PSG findings.
Results
Cross-innervation showed significant correlation with bilateral tongue movement and bilateral tongue base opening, which were associated with better PSG outcomes.
Conclusion
Cross motor innervation of the hypoglossal nerve occurs in approximately 50% of humans, which is associated with a positive effect on PSG outcomes. Bilateral stimulation of the hypoglossal nerve may be a solution for non-responding patients with pronounced collapse at the soft palate during drug-induced sleep endoscopy. |
| doi_str_mv | 10.1007/s11325-020-02112-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7987639</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2504162418</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-f1a7e7f1da52224d98caff5022781bd79cdfbdbdda41a135e0ee510450d1c5323</originalsourceid><addsrcrecordid>eNp9kctu1DAUhiNERUvhBVggS2zYhPo4dh1vkNCoXKRKbGBteezjmVQZO9hOxex4iD4hT4LTactlwSJypPP5s3__TfMC6BugVJ5lgI6JljJaPwDWskfNCQjGWpBUPb79p60SwI6bpzlfUQq8V_CkOe4Y73shu5Pm-yrFnMkulpjIEAKma1OGGEj0pGyRbPdT3IwVMSNZhvjzx40h0zDGQnKZ3X4Bp4RusNWQia-aPFuLOft5JHHCMITNvS1HX8hkRlPwWXPkzZjx-d162nx9f_Fl9bG9_Pzh0-rdZWu55KX1YCRKD87UXIw71VvjvaCMyR7WTirr_NqtnTMcDHQCKaIAygV1YEXHutPm7cE7zesdOouhJDPqKQ07k_Y6mkH_PQnDVm_itZaql-edqoLXd4IUv82Yi94N2eI4moBxzppxqkBxJRf01T_oVZxTqPE0E5TDOePQV4odKLs8fUL_cBmgeilWH4rVtVh9W6xeYrz8M8bDlvsmK9AdgFxHYYPp99n_0f4C_c-yoA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2504162418</pqid></control><display><type>article</type><title>Cross motor innervation of the hypoglossal nerve—a pilot study of predictors for successful opening of the soft palate</title><source>Springer Nature - Complete Springer Journals</source><creator>Heiser, Clemens ; Vanderveken, Olivier M. ; Edenharter, Günther M. ; Hofauer, Benedikt</creator><creatorcontrib>Heiser, Clemens ; Vanderveken, Olivier M. ; Edenharter, Günther M. ; Hofauer, Benedikt</creatorcontrib><description>Purpose
Selective hypoglossal nerve stimulation has proven to be a successful treatment option in patients with obstructive sleep apnea. The aim of this pilot study was to investigate if there is a cross-innervation of the hypoglossal nerve in humans and if patients with this phenotype show a different response to hypoglossal nerve stimulation compared to those with ipsilateral-only innervation
Methods
Nineteen patients who previously received a selective hypoglossal nerve stimulation system (Inspire Medical Systems, Golden Valley, USA) were implanted with a nerve integrity system placing electrodes on both sides of the tongue. Tongue motions were recorded one and two months after surgery from transoral and transnasal views. Polysomnography (PSG) was also performed at two months. Electromyogram (EMG) signals and tongue motions after activation were compared with PSG findings.
Results
Cross-innervation showed significant correlation with bilateral tongue movement and bilateral tongue base opening, which were associated with better PSG outcomes.
Conclusion
Cross motor innervation of the hypoglossal nerve occurs in approximately 50% of humans, which is associated with a positive effect on PSG outcomes. Bilateral stimulation of the hypoglossal nerve may be a solution for non-responding patients with pronounced collapse at the soft palate during drug-induced sleep endoscopy.</description><identifier>ISSN: 1520-9512</identifier><identifier>EISSN: 1522-1709</identifier><identifier>DOI: 10.1007/s11325-020-02112-2</identifier><identifier>PMID: 32488573</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Apnea ; Dentistry ; Electromyography ; Endoscopy ; ENT • Original ; ENT • Original Article ; Hypoglossal nerve ; Innervation ; Internal Medicine ; Medicine ; Medicine & Public Health ; Mouth ; Neurology ; Otorhinolaryngology ; Palate ; Patients ; Pediatrics ; Phenotypes ; Pneumology/Respiratory System ; Sleep ; Sleep disorders ; Surgery ; Tongue</subject><ispartof>Sleep & breathing, 2021-03, Vol.25 (1), p.425-431</ispartof><rights>The Author(s) 2020</rights><rights>The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-f1a7e7f1da52224d98caff5022781bd79cdfbdbdda41a135e0ee510450d1c5323</citedby><cites>FETCH-LOGICAL-c474t-f1a7e7f1da52224d98caff5022781bd79cdfbdbdda41a135e0ee510450d1c5323</cites><orcidid>0000-0001-6301-2891 ; 0000-0003-4248-1976 ; 0000-0002-3126-2877 ; 0000-0002-4088-4213</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11325-020-02112-2$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11325-020-02112-2$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,777,781,882,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32488573$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Heiser, Clemens</creatorcontrib><creatorcontrib>Vanderveken, Olivier M.</creatorcontrib><creatorcontrib>Edenharter, Günther M.</creatorcontrib><creatorcontrib>Hofauer, Benedikt</creatorcontrib><title>Cross motor innervation of the hypoglossal nerve—a pilot study of predictors for successful opening of the soft palate</title><title>Sleep & breathing</title><addtitle>Sleep Breath</addtitle><addtitle>Sleep Breath</addtitle><description>Purpose
Selective hypoglossal nerve stimulation has proven to be a successful treatment option in patients with obstructive sleep apnea. The aim of this pilot study was to investigate if there is a cross-innervation of the hypoglossal nerve in humans and if patients with this phenotype show a different response to hypoglossal nerve stimulation compared to those with ipsilateral-only innervation
Methods
Nineteen patients who previously received a selective hypoglossal nerve stimulation system (Inspire Medical Systems, Golden Valley, USA) were implanted with a nerve integrity system placing electrodes on both sides of the tongue. Tongue motions were recorded one and two months after surgery from transoral and transnasal views. Polysomnography (PSG) was also performed at two months. Electromyogram (EMG) signals and tongue motions after activation were compared with PSG findings.
Results
Cross-innervation showed significant correlation with bilateral tongue movement and bilateral tongue base opening, which were associated with better PSG outcomes.
Conclusion
Cross motor innervation of the hypoglossal nerve occurs in approximately 50% of humans, which is associated with a positive effect on PSG outcomes. Bilateral stimulation of the hypoglossal nerve may be a solution for non-responding patients with pronounced collapse at the soft palate during drug-induced sleep endoscopy.</description><subject>Apnea</subject><subject>Dentistry</subject><subject>Electromyography</subject><subject>Endoscopy</subject><subject>ENT • Original</subject><subject>ENT • Original Article</subject><subject>Hypoglossal nerve</subject><subject>Innervation</subject><subject>Internal Medicine</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mouth</subject><subject>Neurology</subject><subject>Otorhinolaryngology</subject><subject>Palate</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Phenotypes</subject><subject>Pneumology/Respiratory System</subject><subject>Sleep</subject><subject>Sleep disorders</subject><subject>Surgery</subject><subject>Tongue</subject><issn>1520-9512</issn><issn>1522-1709</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kctu1DAUhiNERUvhBVggS2zYhPo4dh1vkNCoXKRKbGBteezjmVQZO9hOxex4iD4hT4LTactlwSJypPP5s3__TfMC6BugVJ5lgI6JljJaPwDWskfNCQjGWpBUPb79p60SwI6bpzlfUQq8V_CkOe4Y73shu5Pm-yrFnMkulpjIEAKma1OGGEj0pGyRbPdT3IwVMSNZhvjzx40h0zDGQnKZ3X4Bp4RusNWQia-aPFuLOft5JHHCMITNvS1HX8hkRlPwWXPkzZjx-d162nx9f_Fl9bG9_Pzh0-rdZWu55KX1YCRKD87UXIw71VvjvaCMyR7WTirr_NqtnTMcDHQCKaIAygV1YEXHutPm7cE7zesdOouhJDPqKQ07k_Y6mkH_PQnDVm_itZaql-edqoLXd4IUv82Yi94N2eI4moBxzppxqkBxJRf01T_oVZxTqPE0E5TDOePQV4odKLs8fUL_cBmgeilWH4rVtVh9W6xeYrz8M8bDlvsmK9AdgFxHYYPp99n_0f4C_c-yoA</recordid><startdate>20210301</startdate><enddate>20210301</enddate><creator>Heiser, Clemens</creator><creator>Vanderveken, Olivier M.</creator><creator>Edenharter, Günther M.</creator><creator>Hofauer, Benedikt</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7T5</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>88J</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2R</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-6301-2891</orcidid><orcidid>https://orcid.org/0000-0003-4248-1976</orcidid><orcidid>https://orcid.org/0000-0002-3126-2877</orcidid><orcidid>https://orcid.org/0000-0002-4088-4213</orcidid></search><sort><creationdate>20210301</creationdate><title>Cross motor innervation of the hypoglossal nerve—a pilot study of predictors for successful opening of the soft palate</title><author>Heiser, Clemens ; Vanderveken, Olivier M. ; Edenharter, Günther M. ; Hofauer, Benedikt</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-f1a7e7f1da52224d98caff5022781bd79cdfbdbdda41a135e0ee510450d1c5323</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Apnea</topic><topic>Dentistry</topic><topic>Electromyography</topic><topic>Endoscopy</topic><topic>ENT • Original</topic><topic>ENT • Original Article</topic><topic>Hypoglossal nerve</topic><topic>Innervation</topic><topic>Internal Medicine</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mouth</topic><topic>Neurology</topic><topic>Otorhinolaryngology</topic><topic>Palate</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Phenotypes</topic><topic>Pneumology/Respiratory System</topic><topic>Sleep</topic><topic>Sleep disorders</topic><topic>Surgery</topic><topic>Tongue</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Heiser, Clemens</creatorcontrib><creatorcontrib>Vanderveken, Olivier M.</creatorcontrib><creatorcontrib>Edenharter, Günther M.</creatorcontrib><creatorcontrib>Hofauer, Benedikt</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Social Science Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Social Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Sleep & breathing</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Heiser, Clemens</au><au>Vanderveken, Olivier M.</au><au>Edenharter, Günther M.</au><au>Hofauer, Benedikt</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cross motor innervation of the hypoglossal nerve—a pilot study of predictors for successful opening of the soft palate</atitle><jtitle>Sleep & breathing</jtitle><stitle>Sleep Breath</stitle><addtitle>Sleep Breath</addtitle><date>2021-03-01</date><risdate>2021</risdate><volume>25</volume><issue>1</issue><spage>425</spage><epage>431</epage><pages>425-431</pages><issn>1520-9512</issn><eissn>1522-1709</eissn><abstract>Purpose
Selective hypoglossal nerve stimulation has proven to be a successful treatment option in patients with obstructive sleep apnea. The aim of this pilot study was to investigate if there is a cross-innervation of the hypoglossal nerve in humans and if patients with this phenotype show a different response to hypoglossal nerve stimulation compared to those with ipsilateral-only innervation
Methods
Nineteen patients who previously received a selective hypoglossal nerve stimulation system (Inspire Medical Systems, Golden Valley, USA) were implanted with a nerve integrity system placing electrodes on both sides of the tongue. Tongue motions were recorded one and two months after surgery from transoral and transnasal views. Polysomnography (PSG) was also performed at two months. Electromyogram (EMG) signals and tongue motions after activation were compared with PSG findings.
Results
Cross-innervation showed significant correlation with bilateral tongue movement and bilateral tongue base opening, which were associated with better PSG outcomes.
Conclusion
Cross motor innervation of the hypoglossal nerve occurs in approximately 50% of humans, which is associated with a positive effect on PSG outcomes. Bilateral stimulation of the hypoglossal nerve may be a solution for non-responding patients with pronounced collapse at the soft palate during drug-induced sleep endoscopy.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>32488573</pmid><doi>10.1007/s11325-020-02112-2</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-6301-2891</orcidid><orcidid>https://orcid.org/0000-0003-4248-1976</orcidid><orcidid>https://orcid.org/0000-0002-3126-2877</orcidid><orcidid>https://orcid.org/0000-0002-4088-4213</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Sleep & breathing, 2021-03, Vol.25 (1), p.425-431 |
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| source | Springer Nature - Complete Springer Journals |
| subjects | Apnea Dentistry Electromyography Endoscopy ENT • Original ENT • Original Article Hypoglossal nerve Innervation Internal Medicine Medicine Medicine & Public Health Mouth Neurology Otorhinolaryngology Palate Patients Pediatrics Phenotypes Pneumology/Respiratory System Sleep Sleep disorders Surgery Tongue |
| title | Cross motor innervation of the hypoglossal nerve—a pilot study of predictors for successful opening of the soft palate |
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