The effect of neuromuscular stimulation of the genioglossus on the hypopharyngeal airway.
OBJECTIVE
To determine the effects of neuromuscular stimulation (NS) of the genioglossus muscle on hypopharyngeal airway size.


METHODS
Fourteen consecutively recruited healthy volunteers underwent percutaneous electrical NS of the genioglossus muscle.


METHODS
Bipolar hooked wires were inserted percutaneously into the genioglossus muscle and used for NS. The anterior--posterior diameter of the hypopharynx was measured at the level of the superior edge of the epiglottis at baseline and during NS from recorded video endoscopic examinations.


RESULTS
NS of the genioglossus muscle resulted in a significant increase in the diameter of the hypopharyngeal airway (P =.002) compared with baseline, ranging from a 33% to 284% increase in airway diameter. Three of the 14 patients demonstrated modest decreases in airway diameter, likely the result of faulty electrode placement in surrounding tongue retrusive muscles.


CONCLUSIONS
NS of the genioglossus muscle was effective in increasing the hypopharyngeal airway and may provide a useful alternative to direct stimulation of the hypoglossal nerve with a nerve cuff electrode in the development of neuroprosthetic treatments for obstructive sleep apnea.
Mann
Eric A
EA
Laryngeal and Speech Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892-1416, USA. manne@ninds.nih.gov
Burnett
Theresa
T
Cornell
Sonia
S
Ludlow
Christy L
CL
D000328:Adult; D000403:Airway Resistance; D000704:Analysis of Variance; D004558:Electric Stimulation / Q000379:methods*; D005260:Female; D006801:Humans; D007013:Hypopharynx / Q000502:physiology*; D007828:Laryngoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction; D009126:Muscle Relaxation; D010609:Pharyngeal Muscles / Q000294:innervation* / Q000502:physiology*; D011446:Prospective Studies; D012016:Reference Values; D015656:Respiratory Mechanics / Q000502:physiology; D012680:Sensitivity and Specificity; D014741:Video Recording