舌下神经刺激过度滴定。
Hypoglossal nerve stimulation over-titration.
机构信息
Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.
Division of Pulmonary, Critical Care, and Sleep Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California.
出版信息
J Clin Sleep Med. 2024 Jun 1;20(6):999-1001. doi: 10.5664/jcsm.11066.
UNLABELLED
This case report reviews worsening obstructive sleep apnea (OSA) events in a patient over-titrated with a hypoglossal nerve stimulator. A healthy 57-year-old man underwent hypoglossal nerve stimulator implantation for moderate OSA. During an in-laboratory hypoglossal nerve stimulator titration the patient had improvement of his OSA at 2.1 V. However, a further increase of voltage resulted in worsening of obstructive events. The pathophysiology behind this finding is unknown but may result from unfavorable changes in the upper anatomy due to higher energy delivered to the hypoglossal nerve and surrounding structures. This high energy may also lead to genioglossus muscle fatigue. This finding highlights the importance of hypoglossal nerve stimulation titration with a dedicated sleep study.
CITATION
Chang M, Moore V, Eng K, Ryden A, Zeidler M. Hypoglossal nerve stimulation over-titration. . 2024;20(6):999-1001.
本病例报告回顾了一位舌下神经刺激器过度刺激的患者中阻塞性睡眠呼吸暂停（OSA）事件恶化的情况。一位 57 岁健康男性因中度 OSA 接受了舌下神经刺激器植入术。在实验室进行舌下神经刺激器滴定期间，患者在 2.1V 时 OSA 得到改善。然而，电压进一步增加导致阻塞事件恶化。这种发现背后的病理生理学尚不清楚，但可能是由于传递到舌下神经和周围结构的更高能量导致上呼吸道解剖结构的不利变化所致。这种高能量也可能导致颏舌肌疲劳。这一发现强调了进行专门的睡眠研究来调整舌下神经刺激器的重要性。
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