Department of Otolaryngology, Head and Neck Surgery, University of California, San Francisco School of Medicine, San Francisco, California, USA.
Sleep Med Rev. 2010 Oct;14(5):299-305. doi: 10.1016/j.smrv.2009.10.009. Epub 2010 Jan 29.
Upper airway occlusion in obstructive sleep apnea has been attributed to a decline in pharyngeal neuromuscular activity occurring in a structurally narrowed airway. Surgical treatment focuses on the correction of anatomic abnormalities, but there is a potential role for activation of the upper airway musculature, especially with stimulation of the hypoglossal nerve and genioglossus muscle. We present evidence from research on upper airway neuromuscular electrical stimulation in animals and humans. We also present results from eight obstructive sleep apnea patients with a fully implanted system for hypoglossal nerve stimulation, demonstrating an improvement in upper airway collapsibility and obstructive sleep apnea severity. Future research, including optimization of device features and stimulation parameters as well as patient selection, is necessary to make hypoglossal nerve stimulation a viable alternative to positive airway pressure therapy and upper airway surgical procedures.
上气道阻塞在阻塞性睡眠呼吸暂停中归因于发生在结构狭窄气道中的咽神经肌肉活动的下降。手术治疗侧重于解剖异常的矫正，但上气道肌肉的激活具有潜在作用，特别是舌下神经和颏舌肌的刺激。我们从动物和人类的上气道神经肌肉电刺激研究中提供证据。我们还从八位接受完全植入式舌下神经刺激系统的阻塞性睡眠呼吸暂停患者中提供结果，表明上气道塌陷性和阻塞性睡眠呼吸暂停严重程度得到改善。未来的研究，包括优化设备功能和刺激参数以及患者选择，对于使舌下神经刺激成为正压通气治疗和上气道手术的可行替代方法是必要的。
