Electrical Stimulation of the Genioglossus in Patients with Residual Obstructive Sleep Apnea Post-UPPP Surgery
Yan-Bin Dong, Ning Ding, Wen-Xiao Ding, Ling-Ling Ji, Xilong Zhang*
Department of Respiratory Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China
- *Corresponding Author:
- Xilong Zhang
Department of Respiratory Medicine
The First Affiliated Hospital with Nanjing Medical University
300 Guangzhou Road
Nanjing 210029, China
E-mail: [email protected]
Receiving date: Feb 10, 2016; Accepted date: Feb 25, 2016; Publishing date: Feb 29, 2016
Citation: Dong YB, Ding N, Ding WX, Ji LL, Zhang X (2016) Electrical Stimulation of the Genioglossus in Patients with Residual Obstructive Sleep Apnea Post-UPPP Surgery. Intern Med 6:216. doi:10.4172/2165-8048.1000216
Copyright: © 2016 Dong YB. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objective: Genioglossus is a major upper-airway dilator muscle, which leads to upper-airway obstruction when its activity is decreased. We evaluated the effect and safety of genioglossus stimulation for patients with residual mild-to-moderate obstructive sleep apnea (OSA) after uvulopalatopharyngoplasty (UPPP).
Methods: We enrolled 23 patients diagnosed with OSA by polysomnography (PSG) 6 months after UPPP, who underwent nightly transcutaneous genioglossus stimulation (TGS) therapy. Apnea hypopnea index (AHI), microarousal index (MAI), the ratio of duration of SpO2 < 90% to total sleep time (T90) and Epworth sleepiness scale (ESS) before and during TGS treatment were compared. We first observed the overall effect of TGS, and then compared its influence on patients with mild and moderate sleep apnea.
Results: Compared with non-TGS therapy, there was a significant decrease in AHI, MAI, T90, and ESS (9.15 ± 4.21 vs. 17.90 ± 6.85, p < 0.0001; 6.33 ± 3.75 vs. 10.93 ± 4.90, p < 0.0001; 4.87 ± 4.02 vs. 9.13 ± 4.24, p < 0.0001; 8.65 ± 3.35 vs. 9.30 ± 3.10, p = 0.002, respectively), and a significant increase in mean SpO2 and minimal SpO2 (mini SpO2) (95.52% ± 0.95% vs. 94.43% ± 1.12%, p < 0.0001; 88.74% ± 2.94% vs. 85.17% ± 4.67%, p < 0.0001, respectively) during TGS treatment. Patients in the mild and moderate groups had the same variation trend between TGS and non-TGS therapy nights. However, the moderate group had a higher absolute value of changed AHI (âÂ³AHI; 11.12 ± 3.95 vs. 5.66 ± 1.70, p < 0.05) and MAI (âÂ³MAI; 5.8 (3.3, 8.6) vs. 2.5 (1.05, 5.6), p < 0.05) than the mild group. There were no significant differences in absolute changed mean SpO2 (âÂ³mean SpO2), absolute changed miniSpO2 (âÂ³miniSpO2), changed T90 (âÂ³T90) and absolute changed ESS (âÂ³ESS) between the two groups. Moreover, the percentage of âÂ³AHI was not different between the two groups (47.89% ± 13.79% vs. 51.04% ± 13.32%, p = 0.587). There was no perceived discomfort during TGS therapy and no procedure-related adverse events.
Conclusion: Submental transcutaneous electrical stimulation of the genioglossus led to a significant reduction in AHI and improvement of daytime sleepiness for existing mild-to-moderate OSA patient’s post-UPPP surgery.