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December 1995

The Effects of Selective Nerve Stimulation on Upper Airway Airflow Mechanics

Author Affiliations

From the Department of Otolaryngology—Head and Neck Surgery (Drs Eisele and Hari), and the Division of Pulmonary and Critical Care Medicine, Johns Hopkins Sleep Disorders Center (Drs Schwartz and Smith and Mr Thut), The Johns Hopkins University School of Medicine, Baltimore, Md.

Arch Otolaryngol Head Neck Surg. 1995;121(12):1361-1364. doi:10.1001/archotol.1995.01890120021004

Objective:  To evaluate the effect of electrical stimulation of hypoglossal nerve branches and ansa cervicalis nerve branches on upper airway patency.

Design:  Pressure-flow relationships obtained during supramaximal stimulation of hypoglossal nerve branches and ansa cervicalis nerve branches were analyzed in the isolated feline upper airway to determine the maximum inspiratory airflow as well as to determine pharyngeal collapsibility (upper airway critical pressure) and nasal resistance upstream from the site of pharyngeal collapse. Comparisons were performed between baseline and stimulation conditions with paired two-tailed t tests.

Results:  Stimulation of the proximal hypoglossal nerve trunk, distal medial hypoglossal nerve branch, nerve branches to the suprahyoid muscles, the infrahyoid muscles, and the suprahyoid and infrahyoid muscles simultaneously increased maximum inspiratory airflow significantly by decreasing airway collapsibility. A greater reduction in airway collapsibility was observed with stimulation of the tongue muscles compared with stimulation of the strap muscles.

Conclusions:  Stimulation of specific hypoglossal and ansa cervicalis nerve branches consistently increased maximum inspiratory airflow by decreasing airway collapsibility. The major decrease in airway collapsibility from hypoglossal nerve stimulation is dependent on the action of the genioglossus muscle.(Arch Otolaryngol Head Neck Surg. 1995;121:1361-1364)

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