CC BY-NC-ND 4.0 · Laryngorhinootologie 2019; 98(S 02): S189-S190
DOI: 10.1055/s-0039-1686800
Abstracts
Sleeping Disorders

Innovative neuromodulation concepts for the treatment of obstructive sleep apnea

JT Maurer
1   Klinik f. HNO-Heilkunde, KHC, Schlafmedizinisches Zentrum, Mannheim
,
J Perkins
2   Department of Veterinary Clinical Sciences, Royal Veterinary College, London, Großbritannien
› Author AffiliationsMed-El, Insbruck, Österreich
› Further Information
Also available at
 

Introduction:

In obstructive sleep apnea (OSA), genioglossus muscle (GG) activity shows a steep decrease during sleep. Furthermore, impaired pharyngeal afferent activity has been shown. Thus increasing reflexive GG-activity through electrical afferent stimulation may represent a treatment option.

Objective:

Acute evaluation of the ipsilateral and contralateral GG response to electrical stimulation delivered on the internal branch of the superior laryngeal nerve (iSLN) in a canine model.

Method:

17 female mongrels of 8.4 ± 1.2months and 21.6 ± 2.5 kg were anesthetized with sevoflurane. A bipolar nerve cuff-electrode was placed on the right iSLN. Stimulation was delivered in 10 – 100 Hz burst frequency, 1 – 20 s burst duration, 40 – 480µs pulse duration, and stimulation amplitude of 0.05 – 10mA. Hook-wire electrodes were inserted into both GGs, and other ipsilateral upper airway muscles to record their electromyographic (EMG) activity. pCO2 was monitored throughout the stimulation. Institutional Animal Care and Use Committee, approval N° 285 – 03.

Results:

Stimulation intensity above the threshold (Ith) of 264 ± 152µA increased the respiratory cycle length by delaying the next inspiration. Stimulation with 3 s burst duration, 40 Hz burst frequency, 200µs pulse duration, and I/Ith≤3.5 reproducibly evoked ipsilateral GG EMG activity in 13 of the 17 dogs with a mean duration of 121 s ± 84 s. In this case, the next inspiration is delayed by 3.6 s ± 2.3 s. In addition, longer burst duration elicited longer EMG responses.

Conclusions:

ISLN stimulation can evoke a specific ipsilateral GG-response. These preliminary data suggest potential clinical use of this method for OSA treatment.



Publication History

Publication Date:
23 April 2019 (online)

© 2019. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Stuttgart · New York