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Head Neck. 2017 Dec;39(12):2371-2380. doi: 10.1002/hed.24864. Epub 2017 Sep 27.

Surgical anatomy of the hypoglossal nerve: A new classification system for selective upper airway stimulation.

Author information

1
Department of Otorhinolaryngology, Head and Neck Surgery, Technische Universität München, Munich, Germany.

Abstract

BACKGROUND:

Selective upper airway stimulation (UAS) has shown effectiveness in treating patients with obstructive sleep apnea (OSA). The terminating branches of the hypoglossal nerve show a wide complexity, requiring careful discernment of a functional breakpoint between branches for inclusion and exclusion from the stimulation cuff electrode. The purpose of this study was to describe and categorize the topographic phenotypes of these branches.

METHODS:

Thirty patients who received an implant with selective UAS from July 2015 to June 2016 were included. All implantations were recorded using a microscope and resultant tongue motions were captured perioperatively for comparison.

RESULTS:

Eight different variations of the branches were encountered and described, both in a tabular numeric fashion and in pictorial schema.

CONCLUSION:

The examinations showed the complex phenotypic surgical anatomy of the hypoglossal nerve. A schematic classification system has been developed to help surgeons identify the optimal location for cuff placement in UAS.

KEYWORDS:

anatomy hypoglossal nerve; hypoglossal nerve; obstructive sleep apnea; surgical treatment obstructive sleep apnea; upper airway stimulation

PMID:
28960569
DOI:
10.1002/hed.24864
[Indexed for MEDLINE]

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