title: Palatoglossus coupling in selective upper airway stimulation.
abstract: Selective upper airway stimulation (sUAS) of the hypoglossal nerve is a useful therapy to treat patients with obstructive sleep apnea. Is it known that multiple obstructions can be solved by this stimulation technique, even at the retropalatal region. The aim of this study was to verify the palatoglossus coupling at the soft palate during stimulation.
  
  
  
  Single-center, prospective clinical trail.
  
  
  
  Twenty patients who received an sUAS implant from April 2015 to April 2016 were included. A drug-induced sedated endoscopy (DISE) was performed before surgery. Six to 12 months after activation of the system, patients' tongue motions were recorded, an awake transnasal endoscopy was performed with stimulation turned on, and a DISE with stimulation off and on was done.
  
  
  
  Patients with a bilateral protrusion of the tongue base showed a significantly increased opening at the retropalatal level compared to ipsilateral protrusions. Furthermore, patients with a clear activation of the geniohyoid muscle showed a better reduction in apnea-hypopnea index.
  
  
  
  A bilateral protrusion of the tongue base during sUAS seems to be accompanied with a better opening of the soft palate. This effect can be explained by the palatoglossal coupling, due to its linkage of the muscles within the soft palate to those of the lateral tongue body.
  
  
  
  4 Laryngoscope, 127:E378-E383, 2017.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Technical University of Munich, Munich, Germany.
authors.forename: Clemens
authors.initials: C
authors.lastname: Heiser
authors.affiliation: Department of Anesthesiology, Rechts der Isar Hospital, Technical University of Munich, Munich, Germany.
authors.forename: Günther
authors.initials: G
authors.lastname: Edenharter
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Technical University of Munich, Munich, Germany.
authors.forename: Murat
authors.initials: M
authors.lastname: Bas
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Technical University of Munich, Munich, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Wirth
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Technical University of Munich, Munich, Germany.
authors.forename: Benedikt
authors.initials: B
authors.lastname: Hofauer
mesh_terms: D000368:Aged; D004599:Electric Stimulation Therapy / Q000295:instrumentation / Q000379:methods*; D056966:Excitation Contraction Coupling; D006801:Humans; D007002:Hypoglossal Nerve / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods; D009666:Nose / Q000601:surgery; D010156:Palatal Muscles / Q000294:innervation / Q000503:physiopathology*; D010160:Palate, Soft / Q000294:innervation / Q000503:physiopathology; D011446:Prospective Studies; D019919:Prosthesis Implantation / Q000379:methods; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology / Q000601:surgery*; D014059:Tongue / Q000503:physiopathology; D016896:Treatment Outcome
keywords: Selective upper airway stimulation; hypoglossal nerve; obstructive sleep apnea; surgical treatment