Skip to main content

Advertisement

SpringerLink
Log in

Development of a standardized evaluation of endobuccal adverse events induced by repeated tongue protrusion with both a dedicated questionnaire and an endobuccal examination

  • Short Communication
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Introduction

A new approach to treat obstructive sleep apnea (OSA) is upper airway stimulation therapy (UAS). Electrical pulses applied to the hypoglossal nerve induce tongue protrusion, increase airway patency and decrease the frequency of apneic and hypopneic events. Thus, the main objective of this study was to design a standardized evaluation of endobuccal adverse events induced by repeated tongue protrusion with both a dedicated questionnaire and an endobuccal examination.

Method

This study has designed the Tongue Adverse Event and Satisfaction Questionnaire (TAESQ) and an endobuccal examinations divided into an endobuccal lesion examination (ELE) and an endobuccal risk factor examination (ERFE). Evaluations were conducted at month 6 post-implantation.

Results

The study population after implantation of UAS device consisted of ten Caucasian males with a mean age of 51.9 ± 11.8 years, and a mean BMI of 28.6 ± 3.3. The AHI of the ten participants ranged from 46.7 ± 12.2/h at baseline to 14.5 ± 8.9/h with the Inspire therapy at the 6-month follow-up. The TAESQ revealed pain (30%), followed by less tongue sensitivity (20%) and tongue weakness (10%). The ELE did not reveal any lesions. The ERFE revealed that some participants had tissue and dental risk factors but not associated to more adverse events.

Conclusion

The TAESQ, ELE and ERFE have been designed and studied on a small number of participants. These evaluations could systematically be included in the care pathway of patients treated by UAS to better investigate tongue discomfort and tongue lesion for patients treated with this technology.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Abbreviations

UAS:

Upper airway stimulation

BMI:

Body Mass Index

AHI:

Apnea Hypopnea Index

OSA:

Obstructive sleep apnea

CPAP:

Continuous positive airway pressure

IPG:

Implantable pulse generator

HGN:

Hypoglossal nerve

STAR:

Stimulation treatment for apnea reduction

TAESQ:

Tongue Adverse Event and Satisfaction Questionnaire

CSQ8:

Client Satisfaction Questionnaire 8

DISE:

Drug-induced sleep endoscopy

References

  1. Gay P, Weaver T, Loube D, Iber C (2006) Evaluation of positive airway pressure treatment for sleep related breathing disorders in adults. Sleep Mars 29(3):381–401

    Article  Google Scholar 

  2. Kribbs NB, Pack AI, Kline LR, Smith PL, Schwartz AR, Schubert NM et al (1993) Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnea. Am Rev Respir Dis 147(4):887–895

    Article  PubMed  CAS  Google Scholar 

  3. Philip P, Bioulac S, Altena E, Morin CM, Ghorayeb I, Coste O et al (2018) Specific insomnia symptoms and self-efficacy explain CPAP compliance in a sample of OSAS patients. In: Romigi A (ed) PLoS One 13(4):e0195343

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  4. Fujita S, Conway W, Zorick F, Roth T (1981) Surgical correction of anatomic abnormalities in obstructive sleep apnea syndrome: uvulopalatopharyngoplasty. Otolaryngol Head Neck Surg 89(6):923–934

    Article  PubMed  CAS  Google Scholar 

  5. Afonso Delgado L, Micoulaud Franchi J-A, Monteyrol P-J, Philip P (2016) Traitement du syndrome d’apnées et hypopnées obstructives du sommeil par stimulation nerveuse implantable. La Presse Méd Févr 45(2):183–192

    Article  Google Scholar 

  6. Eastwood PR, Barnes M, Walsh JH, Maddison KJ, Hee G, Schwartz AR et al (2011) Treating obstructive sleep apnea with hypoglossal nerve stimulation. Sleep 34(11):1479–1486

    Article  PubMed  PubMed Central  Google Scholar 

  7. Maurer JT, Van de Heyning P, Lin H-S, Baskin J, Anders C, Hohenhorst W et al (2012) Operative technique of upper airway stimulation: an implantable treatment of obstructive sleep apnea. Oper Tech Otolaryngol Head Neck Surg 23(3):227–33

    Article  Google Scholar 

  8. Strollo PJ, Soose RJ, Maurer JT, de Vries N, Cornelius J, Froymovich O et al (2014) Upper-airway stimulation for obstructive sleep apnea. N Engl J Med 370(2):139–149

    Article  PubMed  CAS  Google Scholar 

  9. Woodson BT, Strohl KP, Soose RJ, Gillespie MB, Maurer JT, de Vries N et al (2018) Upper airway stimulation for obstructive sleep apnea: 5-year outcomes. Otolaryngol Head Neck Surg 159(1):194–202

    Article  PubMed  Google Scholar 

  10. Van de Heyning PH, Badr MS, Baskin JZ, Cramer Bornemann MA, De Backer WA, Dotan Y et al (2012) Implanted upper airway stimulation device for obstructive sleep apnea. Laryngoscope 122(7):1626–1633

    Article  PubMed  Google Scholar 

  11. Strollo PJ, Gillespie MB, Soose RJ, Maurer JT, de Vries N, Cornelius J et al (2015) Upper airway stimulation for obstructive sleep apnea: durability of the treatment effect at 18 months. Sleep 38(10):1593–1598

    Article  PubMed  PubMed Central  Google Scholar 

  12. Vanderveken OM, Maurer JT, Hohenhorst W, Hamans E, Lin H-S, Vroegop AV et al (2013) Evaluation of drug-induced sleep endoscopy as a patient selection tool for implanted upper airway stimulation for obstructive sleep apnea. J Clin Sleep Med. http://jcsm.aasm.org/ViewAbstract.aspx?pid=28942. Cite 2 Aug 2018 (Internet)

  13. Certal VF, Zaghi S, Riaz M, Vieira AS, Pinheiro CT, Kushida C et al (2015) Hypoglossal nerve stimulation in the treatment of obstructive sleep apnea: a systematic review and meta-analysis: hypoglossal nerve stimulation in OSA. Laryngoscope 125(5):1254–1264

    Article  PubMed  Google Scholar 

  14. Eastwood PR, Walsh JH, Maddison KJ, Baker VA, Tesfayesus W, Hillman DR (2010) Treatment of obstructive sleep apnea with unilateral hypoglossal nerve stimulation. American Thoracic Society, pp A5393–A5393. http://www.atsjournals.org/doi/abs/10.1164/ajrccm-conference.2010.181.1_MeetingAbstracts.A5393. Cite 2 Aug 2018

  15. Kezirian EJ, Goding GS, Malhotra A, O’Donoghue FJ, Zammit G, Wheatley JR et al (2014) Hypoglossal nerve stimulation improves obstructive sleep apnea: 12-month outcomes. J Sleep Res 23(1):77–83

    Article  PubMed  Google Scholar 

  16. Mwenge GB, Rombaux P, Dury M, Lengelé B, Rodenstein D (2013) Targeted hypoglossal neurostimulation for obstructive sleep apnoea: a 1-year pilot study. Eur Respir J 41(2):360–367

    Article  PubMed  Google Scholar 

  17. Heiser C, Thaler E, Boon M, Soose RJ, Woodson BT (2016) Updates of operative techniques for upper airway stimulation. Laryngoscope 126(Suppl 7):S12–S16

    Article  PubMed  Google Scholar 

  18. Vanderveken OM, Beyers J, Op de Beeck S, Dieltjens M, Willemen M, Verbraecken JA et al (2017) Development of a clinical pathway and technical aspects of upper airway stimulation therapy for obstructive sleep apnea. Front Neurosci. https://doi.org/10.3389/fnins.2017.00523/full. Cite 2 Aug 2018 (Internet)

    Article  PubMed  PubMed Central  Google Scholar 

  19. Attkisson CC, Zwick R (1982) The client satisfaction questionnaire: psychometric properties and correlations with service utilization and psychotherapy outcome. Eval Program Plan 5(3):233–237

    Article  CAS  Google Scholar 

  20. Nguyen TD, Attkisson CC, Stegner BL (1983) Assessment of patient satisfaction: development and refinement of a service evaluation questionnaire. Eval Program Plan 6(3–4):299–313

    Article  CAS  Google Scholar 

  21. Auriol M-M, Le Naour G (2004) La muqueuse buccale: structure, fonction et examen. Actual Odonto-stomatol 225:7–21

  22. Bercy P, Tenenbaum HP (1996) Parodontologie: du diagnostic à la pratique. De Boeck & Larder, Bruxelles, pp 1–289

    Google Scholar 

  23. Philip P, Heiser C, Bioulac S, Altena E, Penchet G, Cuny E et al (2018) Hypoglossal nerve stimulation on sleep and level of alertness in OSA: a preliminary study. Neurology 91:e615–e619

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This study was possible through a COPSIT grant from the University Hospital of Bordeaux.

Author information

Author notes

  1. Cécile Catella and Jean-Arthur Micoulaud-Franchi equally contributed to this study.

Authors and Affiliations

  1. UFR des Sciences Odontologiques, Université de Bordeaux, Bordeaux, France

    Cécile Catella & Emmanuel d’Incau

  2. Clinique du Sommeil, CHU Pellegrin, Place Amélie-Raba-Léon, 33076, Bordeaux, France

    Jean-Arthur Micoulaud-Franchi, Pierre-Jean Monteyrol & Pierre Philip

  3. Univ. Bordeaux, SANPSY, USR 3413, 33000, Bordeaux, France

    Jean-Arthur Micoulaud-Franchi & Pierre Philip

  4. CNRS-SANPSY, USR 3413, 33000, Bordeaux, France

    Jean-Arthur Micoulaud-Franchi & Pierre Philip

  5. Service de Neuro-chirurgie (E.A., E.C.), CHU de Bordeaux, Place Amélie Raba-Léon, Bordeaux, France

    Emmanuel Cuny

  6. Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium

    Olivier M. Vanderveken

  7. Department ENT, Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium

    Olivier M. Vanderveken

  8. Multidisciplinary Sleep Disorders Center, Antwerp University Hospital, Antwerp, Belgium

    Olivier M. Vanderveken

  9. Pôle Odontologie et Santé Buccale, CHU de Bordeaux, Bordeaux, France

    Emmanuel d’Incau

Authors
  1. Cécile Catella
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jean-Arthur Micoulaud-Franchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Pierre-Jean Monteyrol
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Emmanuel Cuny
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Olivier M. Vanderveken
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Emmanuel d’Incau
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Pierre Philip
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jean-Arthur Micoulaud-Franchi.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Catella, C., Micoulaud-Franchi, JA., Monteyrol, PJ. et al. Development of a standardized evaluation of endobuccal adverse events induced by repeated tongue protrusion with both a dedicated questionnaire and an endobuccal examination. Eur Arch Otorhinolaryngol 276, 901–909 (2019). https://doi.org/10.1007/s00405-019-05298-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-019-05298-8

Keywords

Search

Navigation