Long-term morbidities after implantation of a respiratory sensing hypoglossal nerve stimulator

Objective Morbidity after implantation of a respiratory sensing hypoglossal nerve stimulator has previously been described over a period up to a maximum of 5 years. In our center, the therapy has been performed since 2010. Thus, we survey a course of up to 12 years. It is still unknown which long-term effects the implanted system has and in which cases or how often surgical treatment is required.

Methods This paper analyzes retrospectively the surgically treated complications after implantation of a respiratory sensing hypoglossal nerve stimulator (Inspire Upper Airway Stimulation, UAS) in our hospital since 2010. The reasons for the revision surgery, the procedure and the postoperative course as well as the current evidence are presented.

Results Since 2010, our center performed 161 implantations (m=138, f=23) of Inspire UAS. 24 revisions and 6 explantations were required. Battery replacement (n=12), excessive scarring and fibrosis with cervical motion restriction (n=6), skin atrophy (n=1) and cable defects (n=5) led to revision surgery. Explantations were performed after multiple optimization attempts due to insomnia (n=2), muscular tension and hypersalivation (n=2), need for MRI examination (n=1), and lack of use (n=1) at patient request.

Conclusion The complications observed in our patient population, such as excessive scarring, skin atrophy and massive fibrosis, have not yet been described in the literature. They must be taken into consideration by the manufacturer and have already been incorporated into the improvement of the hardware. Long-term care after implantation of a hypoglossal stimulator is required.

Publication History

Article published online:
12 May 2023