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Less is more - Retrospective analysis of the two-incision implantation technique for hypoglossal nerve stimulation and comparison of respiratory sensing lead curves against the three-incision technique.
Brain Spine
December 2024
Department of Neurosurgery, Johann Wolfgang Goethe University Hospital, Frankfurt, Germany.
Introduction: Breathing-synchronized hypoglossal-nerve stimulation is a treatment option for suitable patients with severe obstructive-sleep-apnoea. The classical implantation technique requires three incisions: submental to place the stimulating-electrode on terminal branches of the hypoglossal-nerve, sub-clavicular to place the impulse generator, and on the lateral chest-wall to place a breathing-sensor lead. A two-incision-technique has been propagated and widely adopted whereby the respiratory-sensing-lead is placed deeper to the IPG-pocket.
View Article and Find Full Text PDFProgressive central cardiorespiratory rate downregulation and intensifying epilepsy lead to sudden unexpected death in epilepsy in mouse model of the most common human ATP1A3 mutation.
Epilepsia
January 2025
Division of Pediatric Neurology and Developmental Medicine, Department of Pediatrics, Duke University, Durham, North Carolina, USA.
Objective: This study was undertaken to test the following hypotheses in the Atp1a3 mouse (which carries the most common human ATP1A3 (the major subunit of the neuronal Na/K-adenosine triphosphatase [ATPase]) mutation, D801N): sudden unexpected death in epilepsy (SUDEP) occurs during seizures and is due to terminal apneas in some and due to lethal cardiac arrhythmias in others; and Atp1a3 mice have central cardiorespiratory dysregulation and abnormal respiratory drive.
Methods: Comparison was made of littermate wild-type and Atp1a3 groups using (1) simultaneous in vivo video-telemetry recordings of electroencephalogram, electrocardiogram, and breathing; (2) whole-body plethysmography; and (3) hypoglossal nerve recordings.
Results: In Atp1a3 mice, (1) SUDEP consistently occurred during seizures that were more severe than preterminal seizures; (2) seizure clustering occurred in periods preceding SUDEP; (3) slowing of breathing rate (BR) and heart rate was observed preictally before preterminal and terminal seizures; and (4) the sequence during terminal seizures was as follows: bradypnea with bradycardia/cardiac arrhythmias, then terminal apnea, followed by terminal cardiac arrhythmias.
Perineural spread evaluation of cranial nerves in nasopharyngeal carcinoma: superiority and reliability of isovolumetric MR imaging.
Front Oncol
November 2024
Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.
Purpose: The purpose of this study was to investigate the advantage of three-dimensional liver acquisition with volume acceleration-flexible (3D LAVA_Flex) for perineural spread (PNS) status of nasopharyngeal carcinoma (NPC) in comparison with two-dimensional magnetic resonance sequences.
Materials And Methods: Sixty pathological proved NPC patients were prospective enrolled. A protocol included T2-weighted imaging with fat suppression (T2WI fs), T1-weighted imaging (T1WI) without and with contrast enhancement (T1WI ce), and 3D LAVA_Flex was applied for the recruited subject.
Article Synopsis
- A study evaluated a new streamlined approach for hypoglossal nerve stimulator (HGNS) implantation, comparing it to a traditional method.
- The streamlined pathway reduced hospital costs by an average of $9,258 and decreased time to surgery by about 3.82 months without compromising clinical outcomes.
- The findings suggest that this new approach could be beneficial for certain patients, but more research is needed to refine patient selection and assess long-term effects.
Comparison of Home Sleep Devices and Sleep Study Testing in Hypoglossal Nerve Stimulation Patients.
Laryngoscope
January 2025
Ohio Sleep Medicine Institute, 4975 Bradenton Ave, Dublin, Ohio, U.S.A.
Objective: Hypoglossal nerve stimulation (HGNS) is an implantable therapy for obstructive sleep apnea (OSA). Therapy efficacy is currently confirmed by a formal sleep study after empiric adjustment by the patient at home based on their subjective experience with the device. Home-based longitudinal apnea hypopnea index (AHI) measurements have the potential to refine HGNS therapeutic amplitude selection with objective data.
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