Specific branches of hypoglossal nerve to genioglossus muscle as a potential target of selective neurostimulation in obstructive sleep apnea: anatomical and morphometric study.
Purpose: To determine the ideal implantation site for selective tongue neurostimulation in obstructive sleep apnea, anatomy of the distal branching of the hypoglossal nerve (HGN) was revisited. Methods: The HGN distal course and intramuscular distribution to the tongue muscles were studied in 17 emb...
| Publicado en: | Surgical & Radiologic Anatomy Vol. 39; no. 5; pp. 507 - 516 |
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| Autores principales: | , , , , , |
| Formato: | Journal Article |
| Publicado: |
Springer Nature
May2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=122710481&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 122710481 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09301038 O1L jtl: Surgical & Radiologic Anatomy issn: 09301038 maglogo: N pubinfo: dt: May2017 vid: 39 iid: 5 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 122710481 144123158 10.1007/s00276-016-1778-7 122710481 ppf: 507 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Specific branches of hypoglossal nerve to genioglossus muscle as a potential target of selective neurostimulation in obstructive sleep apnea: anatomical and morphometric study. aug: au: Delaey, Philippe Duisit, Jérôme Behets, Catherine Duprez, Thierry Gianello, Pierre Lengelé, Benoît affil: Pôle de Morphologie (MORF), Institut de Recherche Expérimentale et Clinique (IREC) , Université Catholique de Louvain , Avenue E. Mounier 52, Bte B1.52.04 1200 Brussels Belgium sug: ab: Purpose: To determine the ideal implantation site for selective tongue neurostimulation in obstructive sleep apnea, anatomy of the distal branching of the hypoglossal nerve (HGN) was revisited. Methods: The HGN distal course and intramuscular distribution to the tongue muscles were studied in 17 embalmed and 5 fresh heads (age 60-98, BMI 20-35). Medial branches supplying selectively the genioglossus (GG) muscle were identified. Then, the distinct bundles entering the oblique (GGo) and horizontal (GGh) parts of the GG were located. Morphometric data were compared to similar measurements made on MRI sections from 12 patients (age 43-71, BMI 18-47). Results: The key facts relevant to optimize stimulation and electrode design are the following: the mean width of both GG muscles in embalmed and fresh cadavers was 20.7 ± 2.9 and 21.4 ± 5 mm, respectively; it is significantly ( p < 0.05) superior to the MRI value of 18.26 ± 2.0 mm. Selective nervous branches for GGh and GGo were located at 52 ± 8% of hyoid bone-mandibular symphysis distance and at 5.8 ± 1.1 mm from the inferior border of the GG muscle. The surface of stimulation is a 4.4 ± 1.1 × 6.9 ± 3.8 mm ellipse. Conclusions: According to our observations, the optimal selective or supra-selective stimulation of the tongue protractor muscles can be performed on the lateral surface of the GG at roughly equal distance between the mandibular symphysis and the hyoid bone, at a depth of about 0.6 cm above the GG lower border. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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