Increased Genioglossus activity following electrical stimulation of the internal Superior Laryngeal Nerve in humans as a potential new way to treat Obstructive Sleep Apnea – preliminary results

Introduction The link between abnormal genioglossus (GG) activity and Obstructive Sleep Apnea (OSA) has been soundly proved. In canine model, increased GG activity could be shown in 18/18 animals after stimulation of the internal superior laryngeal nerve (iSLN). Currently we are conducting a clinical investigation aiming to confirm that iSLN electrostimulation is able to increase the activity of the GG and other upper airway dilating muscles in humans.

Methods 10 patients scheduled for laryngectomy will be included in the study. During surgery, under sevoflurane anesthesia, the exposed iSLN is electrostimulated with a bipolar probe. Ipsi- and contralateral GG and palatoglossus EMG activity is assessed in absence and during stimulation.

Results Initial results on 3 patients show that unilateral iSLN stimulation with current intensity higher than 3.6 mA at 40 Hz is able to elicit a specific tonic EMG-response of the ipsilateral GG lasting beyond the duration of the e delivered stimulation burst for a maximum of 66.3 seconds. This GG response ic accompanied by increased ipsilateral palatoglossus activity.

Conclusions Our initial results suggest that iSLN electrostimulation is able to elicit a specific GG response that, if applied to OSA patients during sleep, may be able to restore sufficient pharyngeal airway stability to effectively counteract the upper airway collapse caused by this disease. Upon conclusion of this study, the same stimulation will be evaluated in sleeping OSA patients to confirm the potential therapeutic value of this procedure.

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Publication History

Article published online:
10 June 2020