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Laryngorhinootologie 2021; 100(11): 914-927
DOI: 10.1055/a-1577-7035
CME-Fortbildung

Die Hypoglossus-Stimulation zur Therapie der obstruktiven Schlafapnoe

Hypoglossal Nerve Stimulation in the Treatment of Obstructive Sleep Apnea
Joachim T. Maurer
1   Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Hals-Chirurgie, Sektion für Schlafmedizin, Universitätsmedizin Mannheim, Mannheim
,
Roman Troia
,
Sarah Leitzbach
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Patienten mit obstruktiver Schlafapnoe (OSA) suchen oft nach einer alternativen Behandlungsmöglichkeit, wenn sie die Positivdrucktherapie (Positive Airway Pressure, PAP) nicht vertragen. Eine unbehandelte OSA geht mit erhöhter Morbidität und Mortalität einher. Sie ist daher behandlungsbedürftig. Mit der Hypoglossus-Stimulation (HS) steht seit einer Dekade erstmals eine funktionell orientierte Therapie zur Verfügung.

Abstract

Reduced genioglossus muscle tone is considered one of the major causes for obstructive sleep apnea (OSA). Hypoglossal nerve stimulation (HNS) keeps the upper airway patent by increasing the muscle tone of the genioglossus muscle being the major airway opener. According to the German S3-Guideline on Sleep Disordered Breathing this treatment is indicated in patients with OSA failing or rejecting positive airway pressure, showing an AHI between 15 and 65, in particular when anatomy is normal and the BMI below 35. In 2021 it has been made available for regular patient care in Germany. However, breathing synchronized, continuous, and bilateral HNS differ in parts relevantly regarding their patient selection criteria, technical features, surgical technique, therapy setting and programming, and daily use for the patient. There are many publications showing the safety, efficacy, and patient satisfaction of breathing synchronized HNS. Less but promising data are available for continuous and the most recent bilateral HNS.

Schlüsselwörter

Obstruktive Schlafapnoe - Hypoglossus-Stimulation - Mikrochirurgie - Funktionelle Therapie

Keywords

Obstructive sleep apnea - Hypoglossal nerve stimulation - Microsurgery - Functional therapy


Publication History

Article published online:
29 October 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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