CC BY-NC-ND 4.0 · Laryngorhinootologie 2022; 101(S 02): S243-S244
DOI: 10.1055/s-0042-1747053
Poster
Sleeping disorders: Implants / Stimulation therapy

Improvement of life quality due to hypoglossal nerve stimulation in a patient with duchenne muscular dystrophy – a case report of a rare form of therapy

Juliane Priese
1   Universitätsklinikum Jena, Klinik für Hals-Nasen- und Ohrenheilkunde Jena
,
Sven Rupprecht
2   Universitätsklinikum Jena, Klinik für Neurologie Jena
,
Gerlin Schneider
1   Universitätsklinikum Jena, Klinik für Hals-Nasen- und Ohrenheilkunde Jena
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Introduction 

In september 2016 the neurological sleep laboratory introduced us a 47 year old patient. The man didn´t ask us for an alternative treatment of his sleep apnea. He needed help because all the previously efforts of re-titration of his nocturnal PAP-therapy were frustrating. He suffers from a duchenne muscular dystrophy. Despite of increasing the pressure of the PAP-therapy continously (IPAP: 17-30mbar; EPAP: 15mbar) and a good compliance in using the therapy he still evolved desaturations through the night with a mixed sleep apnea (AHI 49,8).Material and Methods 

To find out if there are alternative ways of treatment we carried out a drug induced sleep endoscopy (DISE). Throughout the examination we documented the changes in velum, oropharynx, tounge and epoglottis before and after propofol was given.

For evaluation we used the VOTE-classification. During the DISE the patient developed a complete obstruction of the tongue so we indicated the implantation of the hypoglossal nerve stimulation. In september 2018 we performed the operation.Results 

In our annual consultation we have seen a very satisfied patient. The quality of life improved a lot. 6 months after the implantation of the hypoglossal nerve stimulation our patient went through another polysomnography at the neurological sleep laboratory. The results showed a remarkable reduction of the pressure of his PAP-therapy (EPAP: 5-15mbar; deltaPinsp.: 5mbar) and a supression of his sleep apnea events (AHI 2,5/h).Discussion 

The hypoglossal nerve stimulation is an effective alternative for CPAP intolerant patients and a potential sufficient additional therapy for patients with neurological diseases.



Publication History

Article published online:
24 May 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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