5 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • N O V E M B E R 2 0 1 6
What millions of people wouldn't give for a
good night's sleep. Conservative estimates are
that at least 1 in 50 women and at least 1 in 25
men fight a beleaguering battle with obstruc-
tive sleep apnea. And the numbers are increas-
ing as the incidence of obesity grows. Various
surgical procedures can help, but there are few guarantees, and CPAP machines can be both
cumbersome and challenging.
There may soon be an alternative: an implantable device that keeps airways open while OSA
patients sleep by delivering mild electrical signals to the hypoglossal nerve, which controls the
key muscles of the tongue. The stimulation helps keep the tongue from relaxing and blocking
the airway.
The technique is called targeted hypoglossal neurostimulation. It involves implanting a
matchbook-size rechargeable pulse generator called the THN Sleep Therapy System near the
collarbone and a multi-electrode lead in the upper neck. The procedure takes about an hour. The
"pacemaker for the tongue" is turned on at bedtime with a handheld remote, and turned off
when the patient awakens. There are no masks or tubes, and patients say they quickly get used
to the device, reporting little or no discomfort.
FDA-approved clinical trials are ongoing, and an initial study (osmag.net/u3DGMj) showed
promise. Thirteen of 14 patients were successfully implanted with the device, and after 12
months, their AHI — an index used to measure the severity of sleep apnea — was reduced by
53%. The study subjects also had better oxygen
saturation, improved arousal and less daytime
sleepiness. — Jim Burger
TARGETED HYPOGLOSSAL NEUROSTIMULATION
New Procedure May Conquer Sleep Apnea
• A RESTING DEVELOPMENT THN Sleep Therapy is an implanted device designed to
keep the airway open during sleep.
The "pacemaker for the tongue"
is turned on at bedtime with a handheld
remote, and turned off when the patient awakens.
