The Experts below are selected from a list of 321 Experts worldwide ranked by ideXlab platform
Alan R Schwartz - One of the best experts on this subject based on the ideXlab platform.
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Hypoglossal Nerve stimulation improves obstructive sleep apnea 12 month outcomes
Journal of Sleep Research, 2014Co-Authors: Eric J Kezirian, George S Goding, Philip L Smith, Atul Malhotra, Fergal J Odonoghue, Gary Zammit, John R Wheatley, Peter G Catcheside, Alan R SchwartzAbstract:SUMMARY Reduced upper airway muscle activity during sleep is a key contributor to obstructive sleep apnoea pathogenesis. Hypoglossal Nerve stimulation activates upper airway dilator muscles, including the genioglossus, and has the potential to reduce obstructive sleep apnoea severity. The objective of this study was to examine the safety, feasibility and efficacy of a novel Hypoglossal Nerve stimulation system (HGNS � ; Apnex Medical, St Paul, MN, USA) in treating obstructive sleep apnoea at 12 months following implantation. Thirty-one subjects (35% female, age 52.4 9.4 years) with moderate to severe obstructive sleep apnoea and unable to tolerate positive airway pressure underwent surgical implantation and activation of the Hypoglossal Nerve stimulation system in a prospective single-arm interventional trial. Primary outcomes were changes in obstructive sleep apnoea severity (apnoea–hypopnoea index, from in-laboratory polysomnogram) and sleep-related quality of life [Functional Outcomes of Sleep Questionnaire (FOSQ)]. Hypoglossal Nerve stimulation was used on 86 16% of nights for 5.4 1.4 h per night. There was a significant improvement (P < 0.001) from baseline to 12 months in apnoea–hypopnoea index (45.4 17.5 to 25.3 20.6 events h 1 ) and Functional Outcomes of Sleep Questionnaire score (14.2 2.0 to 17.0 2.4), as well as other polysomnogram and symptom measures. Outcomes were stable compared with 6 months following implantation. Three serious device-related adverse events occurred: an infection requiring device removal; and two stimulation lead cuff dislodgements requiring replacement. There were no significant adverse events with onset later than 6 months following implantation. Hypoglossal Nerve stimulation demonstrated favourable safety, feasibility and efficacy.
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therapeutic electrical stimulation of the Hypoglossal Nerve in obstructive sleep apnea
Archives of Otolaryngology-head & Neck Surgery, 2001Co-Authors: Alan R Schwartz, Marc Bennett, Philip L Smith, Wilfried De Backer, Jan Hedner, An Boudewyns, Paul Van De HeyningAbstract:Background Hypoglossal Nerve stimulation has been demonstrated to relieve upper airway obstruction acutely, but its effect on obstructive sleep apnea is not known. Objective To determine the response in obstructive sleep apnea to electrical stimulation of the Hypoglossal Nerve. Methods Eight patients with obstructive sleep apnea were implanted with a device that stimulated the Hypoglossal Nerve unilaterally during inspiration. Sleep and breathing patterns were examined at baseline before implantation and after implantation at 1, 3, and 6 months and last follow-up. Results Unilateral Hypoglossal Nerve stimulation decreased the severity of obstructive sleep apnea throughout the entire study period. Specifically, stimulation significantly reduced the mean apnea-hypopnea indices in non–rapid eye movement (mean ± SD episodes per hour, 52.0 ± 20.4 for baseline nights and 22.6 ± 12.1 for stimulation nights; P P Conclusion The findings demonstrate the feasibility and therapeutic potential for Hypoglossal Nerve stimulation in obstructive sleep apnea.
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Relief of Upper Airway Obstruction With Hypoglossal Nerve Stimulation in the Canine
Laryngoscope, 1998Co-Authors: George S Goding, Philip L Smith, David W. Eisele, Roy L. Testerman, Karen Roertgen, Alan R SchwartzAbstract:Hypoglossal Nerve stimulation was investigated as a method to relieve an induced upper airway obstruction. Six dogs were implanted with a cuff electrode applied to each Hypoglossal Nerve and a pulse generator. After 4 weeks, the Hypoglossal Nerve was stimulated (50% duty cycle) for up to 8 weeks. At 12 weeks a double tracheotomy was placed, with a negative pressure intermittently applied to the upper limb, simulating inspiratory airway pressure. Unilateral Hypoglossal Nerve stimulation improved peak upper airway flow from an average of 0.1 L/s to 1.6 L/s (P = 0.0001). Seventy-seven percent of the maximum possible flow (explanted tracheotomy tube) was obtained with unilateral stimulation. Histopathological evaluation revealed no Nerve damage secondary to chronic stimulation. This study provides support for clinical trials of Hypoglossal stimulation for obstructive sleep apnea.
Philip L Smith - One of the best experts on this subject based on the ideXlab platform.
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Hypoglossal Nerve stimulation improves obstructive sleep apnea 12 month outcomes
Journal of Sleep Research, 2014Co-Authors: Eric J Kezirian, George S Goding, Philip L Smith, Atul Malhotra, Fergal J Odonoghue, Gary Zammit, John R Wheatley, Peter G Catcheside, Alan R SchwartzAbstract:SUMMARY Reduced upper airway muscle activity during sleep is a key contributor to obstructive sleep apnoea pathogenesis. Hypoglossal Nerve stimulation activates upper airway dilator muscles, including the genioglossus, and has the potential to reduce obstructive sleep apnoea severity. The objective of this study was to examine the safety, feasibility and efficacy of a novel Hypoglossal Nerve stimulation system (HGNS � ; Apnex Medical, St Paul, MN, USA) in treating obstructive sleep apnoea at 12 months following implantation. Thirty-one subjects (35% female, age 52.4 9.4 years) with moderate to severe obstructive sleep apnoea and unable to tolerate positive airway pressure underwent surgical implantation and activation of the Hypoglossal Nerve stimulation system in a prospective single-arm interventional trial. Primary outcomes were changes in obstructive sleep apnoea severity (apnoea–hypopnoea index, from in-laboratory polysomnogram) and sleep-related quality of life [Functional Outcomes of Sleep Questionnaire (FOSQ)]. Hypoglossal Nerve stimulation was used on 86 16% of nights for 5.4 1.4 h per night. There was a significant improvement (P < 0.001) from baseline to 12 months in apnoea–hypopnoea index (45.4 17.5 to 25.3 20.6 events h 1 ) and Functional Outcomes of Sleep Questionnaire score (14.2 2.0 to 17.0 2.4), as well as other polysomnogram and symptom measures. Outcomes were stable compared with 6 months following implantation. Three serious device-related adverse events occurred: an infection requiring device removal; and two stimulation lead cuff dislodgements requiring replacement. There were no significant adverse events with onset later than 6 months following implantation. Hypoglossal Nerve stimulation demonstrated favourable safety, feasibility and efficacy.
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therapeutic electrical stimulation of the Hypoglossal Nerve in obstructive sleep apnea
Archives of Otolaryngology-head & Neck Surgery, 2001Co-Authors: Alan R Schwartz, Marc Bennett, Philip L Smith, Wilfried De Backer, Jan Hedner, An Boudewyns, Paul Van De HeyningAbstract:Background Hypoglossal Nerve stimulation has been demonstrated to relieve upper airway obstruction acutely, but its effect on obstructive sleep apnea is not known. Objective To determine the response in obstructive sleep apnea to electrical stimulation of the Hypoglossal Nerve. Methods Eight patients with obstructive sleep apnea were implanted with a device that stimulated the Hypoglossal Nerve unilaterally during inspiration. Sleep and breathing patterns were examined at baseline before implantation and after implantation at 1, 3, and 6 months and last follow-up. Results Unilateral Hypoglossal Nerve stimulation decreased the severity of obstructive sleep apnea throughout the entire study period. Specifically, stimulation significantly reduced the mean apnea-hypopnea indices in non–rapid eye movement (mean ± SD episodes per hour, 52.0 ± 20.4 for baseline nights and 22.6 ± 12.1 for stimulation nights; P P Conclusion The findings demonstrate the feasibility and therapeutic potential for Hypoglossal Nerve stimulation in obstructive sleep apnea.
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Relief of Upper Airway Obstruction With Hypoglossal Nerve Stimulation in the Canine
Laryngoscope, 1998Co-Authors: George S Goding, Philip L Smith, David W. Eisele, Roy L. Testerman, Karen Roertgen, Alan R SchwartzAbstract:Hypoglossal Nerve stimulation was investigated as a method to relieve an induced upper airway obstruction. Six dogs were implanted with a cuff electrode applied to each Hypoglossal Nerve and a pulse generator. After 4 weeks, the Hypoglossal Nerve was stimulated (50% duty cycle) for up to 8 weeks. At 12 weeks a double tracheotomy was placed, with a negative pressure intermittently applied to the upper limb, simulating inspiratory airway pressure. Unilateral Hypoglossal Nerve stimulation improved peak upper airway flow from an average of 0.1 L/s to 1.6 L/s (P = 0.0001). Seventy-seven percent of the maximum possible flow (explanted tracheotomy tube) was obtained with unilateral stimulation. Histopathological evaluation revealed no Nerve damage secondary to chronic stimulation. This study provides support for clinical trials of Hypoglossal stimulation for obstructive sleep apnea.
Paul Van De Heyning - One of the best experts on this subject based on the ideXlab platform.
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Hypoglossal Nerve Stimulator
Otolaryngology-Head and Neck Surgery, 2011Co-Authors: B. Tucker Woodson, Aviram Netzer, Joachim T. Maurer, Winfried Hohenhorst, Paul Van De HeyningAbstract:Objective: OSA is a common cause of sleep morbidity. A novel treatment for obstruction at the level of the tongue is a unilateral Hypoglossal Nerve implant system (Inspire, Inspire Medical, Minneapolis, Minnesota). Study objectives were to assess sleep outcomes in a multicenter academic setting feasibility trial.Method: Nerve stimulation effect on AHI and self reported sleep outcomes were assessed at two and six months (Epworth Sleepiness Score (ESS) and Functional Outcomes of Sleep Questionnaire (FOSQ).Results: Thirty-one subjects underwent placement of a unilateral Hypoglossal Nerve implant (two explanted). Fifty-five percent of subjects at 6 months were AHI responders (AHI < 20/hr. and 50% reduction). In the entire group, ESS improved (baseline=10.7(4.9) 2 months= 8.2(4.0), 6 months= 7.7(4.2), P < .005). At baseline, 2 months and 6 months: ESS improved in both responders (10.4 to 8.0 to 6.6) and non-responders (11.8 to 9.4 to 8.9), and FOSQ improved and normalized in responders (15.6 to 17.1 to 18.0, P...
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therapeutic electrical stimulation of the Hypoglossal Nerve in obstructive sleep apnea
Archives of Otolaryngology-head & Neck Surgery, 2001Co-Authors: Alan R Schwartz, Marc Bennett, Philip L Smith, Wilfried De Backer, Jan Hedner, An Boudewyns, Paul Van De HeyningAbstract:Background Hypoglossal Nerve stimulation has been demonstrated to relieve upper airway obstruction acutely, but its effect on obstructive sleep apnea is not known. Objective To determine the response in obstructive sleep apnea to electrical stimulation of the Hypoglossal Nerve. Methods Eight patients with obstructive sleep apnea were implanted with a device that stimulated the Hypoglossal Nerve unilaterally during inspiration. Sleep and breathing patterns were examined at baseline before implantation and after implantation at 1, 3, and 6 months and last follow-up. Results Unilateral Hypoglossal Nerve stimulation decreased the severity of obstructive sleep apnea throughout the entire study period. Specifically, stimulation significantly reduced the mean apnea-hypopnea indices in non–rapid eye movement (mean ± SD episodes per hour, 52.0 ± 20.4 for baseline nights and 22.6 ± 12.1 for stimulation nights; P P Conclusion The findings demonstrate the feasibility and therapeutic potential for Hypoglossal Nerve stimulation in obstructive sleep apnea.
Wilfried De Backer - One of the best experts on this subject based on the ideXlab platform.
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therapeutic electrical stimulation of the Hypoglossal Nerve in obstructive sleep apnea
Archives of Otolaryngology-head & Neck Surgery, 2001Co-Authors: Alan R Schwartz, Marc Bennett, Philip L Smith, Wilfried De Backer, Jan Hedner, An Boudewyns, Paul Van De HeyningAbstract:Background Hypoglossal Nerve stimulation has been demonstrated to relieve upper airway obstruction acutely, but its effect on obstructive sleep apnea is not known. Objective To determine the response in obstructive sleep apnea to electrical stimulation of the Hypoglossal Nerve. Methods Eight patients with obstructive sleep apnea were implanted with a device that stimulated the Hypoglossal Nerve unilaterally during inspiration. Sleep and breathing patterns were examined at baseline before implantation and after implantation at 1, 3, and 6 months and last follow-up. Results Unilateral Hypoglossal Nerve stimulation decreased the severity of obstructive sleep apnea throughout the entire study period. Specifically, stimulation significantly reduced the mean apnea-hypopnea indices in non–rapid eye movement (mean ± SD episodes per hour, 52.0 ± 20.4 for baseline nights and 22.6 ± 12.1 for stimulation nights; P P Conclusion The findings demonstrate the feasibility and therapeutic potential for Hypoglossal Nerve stimulation in obstructive sleep apnea.
Devin L Brown - One of the best experts on this subject based on the ideXlab platform.
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Hypoglossal Nerve dysfunction and sleep disordered breathing after stroke
Neurology, 2014Co-Authors: Devin L Brown, Ronald D Chervin, James Wolfe, Rebecca Hughes, Maryann Concannon, Lynda D Lisabeth, Kristen L GruisAbstract:Objective: This cross-sectional study of acute ischemic stroke patients examined relationships between Hypoglossal Nerve conduction, sleep-disordered breathing (SDB), and its severity. Methods: Patients within 7 days of stroke underwent nocturnal respiratory monitoring with the ApneaLink device and Hypoglossal Nerve conduction studies. Results: Eighteen of 52 subjects (35% [95% confidence interval: 22%, 49%]) had an abnormal Hypoglossal amplitude and 23 (44% [95% confidence interval: 30%, 59%]) had an abnormal Hypoglossal latency. No differences were identified in Hypoglossal Nerve latency or amplitude between those with (n = 26) and without (n = 26) significant SDB, defined by an apnea-hypopnea index ≥15. However, Hypoglossal Nerve conduction latency was associated (linear regression p Conclusions: Acute ischemic stroke patients have a high prevalence of Hypoglossal Nerve dysfunction. Further studies are needed to explore whether Hypoglossal Nerve dysfunction may be a cause or consequence of SDB in stroke patients and whether this association can provide further insight into the pathophysiology of SDB in this population.
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Hypoglossal Nerve conduction findings in obstructive sleep apnea
Muscle & Nerve, 2010Co-Authors: Sindhu Ramchandren, Ronald D Chervin, James Wolfe, Maryann Concannon, Lynda D Lisabeth, Kirsten L Gruis, James W Albers, Devin L BrownAbstract:Denervation of oropharyngeal muscles in ob- structive sleep apnea (OSA) has been suggested by needle electromyography (EMG) and muscle biopsy, but little is known about oropharyngeal Nerve conduction abnormalities in OSA. We sought to compare Hypoglossal Nerve conduction studies in patients with and without OSA. Unilateral Hypoglossal Nerve conduction studies were performed on 20 subjects with OSA and 20 age-matched controls using standard techniques. Me- dian age was 48 years in OSA subjects and 47 years in con- trols. Hypoglossal compound muscle action potential (CMAP) amplitudes were significantly reduced (P ¼ 0.01, Wilcoxon signed-rank test), but prolongation of latencies in OSA subjects did not reach significance in comparison to those of controls. Among a subgroup of subjects without polyneuropathy (15 pairs), reduced amplitudes in OSA subjects retained borderline significance (P ¼ 0.05). Hypoglossal Nerve conduction abnor- malities may distinguish patients with OSA from controls. These abnormalities could potentially contribute to, or arise from, OSA. Muscle Nerve 42: 257-261, 2010
