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Hypoglossal Nerve Stimulator Surgery for Sleep Apnea

Many people suffering from obstructive sleep apnea start exploring surgical treatment options after trying out the common therapies. One of these options is Inspire – the hypoglossal nerve stimulator. If you aren’t familiar with it, read on to learn everything needed about the Inspire.

Who Should Try the Inspire Placement?

This surgical procedure is recommended for those who have moderate to severe obstructive sleep apnea (with AHI – apnea-hypopnea index – higher than 15). Also, the Inspire stimulator is a good option for those who don’t comply with other sleep equipment or have a BMI (body-mass index) lower than 32.

But, you should determine whether or not you are a good candidate for the Inspire hypoglossal nerve stimulator after having a detailed discussion and consultation with a sleep surgeon. 

First, your doctor will most likely perform a drug-induced sleep endoscopy to check your anatomy. This will help him/ her see whether or not there’s a complete collapse of the airway from all sides. In this case, the patient wouldn’t be a suitable candidate. But, if the procedure shows appropriate anatomy, the Inspire placement may be an option.

The Inspire Placement Surgery

The Inspire stimulator surgical option involves a device that helps obstructive sleep apnea patients improve airflow and reduce sleep apneas occurrence by activating the hypoglossal nerve to tighten the tongue and upper airway muscles. It is a 2-hour surgery with general anesthesia and it is performed by an ENT (ear, nose, and throat) specialist. 

The surgeon puts a stimulation wire first to the hypoglossal nerve and wraps one of the distal branches. Then, a sensing lead is placed along the rib cage so that the muscles in the tongue and airway can be stimulated. Finally, the stimulator is implanted within the right upper chest wall and connected to the wires and sensors. 

Once the surgery is finished, patients are usually sent home if there weren’t any complications. But, they are recommended to avoid strenuous activities for at least two to three weeks after the surgery. Also, patients should return for a follow-up after about one week after the surgery. 

The Inspire Placement Surgery Effectiveness

Studies have found out that the Inspire surgery is quite effective for treating moderate to severe OSA when a sleep equipment therapy isn’t an option. To be more precise, the stimulator reduces the AHI from 30 to 9 per hour, which is a whopping 68% reduction. 

What’s more, those who have undergone the Inspire hypoglossal nerve stimulator surgery report that their daytime sleepiness has also improved. On the Epworth sleepiness scale, the scores of these patients decreased from 11 to 6. 

The Inspire Placement Surgery Complications

As is the case with any other surgical procedure, the Inspire stimulator also may cause certain complications. For instance, one-quarter of patients reported having modest pain, while one-third reported tongue discomfort or abrasion. However, both of these resolve in time.

Also, the surgery may also have some side effects including:

  • infection
  • nerve damage
  • tongue soreness
  • tongue movement restrictions
  • allergic reaction
  • rejection of the implants
  • excessive bleeding
  • continuous pain around the implant
  • difficulty swallowing or speaking
  • scarring around the implant
  • insomnia
  • dry mouth
  • headaches
  • coughing
  • choking

But, if any of the above-mentioned symptoms persist, ensure you consult your surgeon.

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