2021 Journal of applied physiology (Bethesda, Md. : 1985)
* Ansa cervicalis stimulation increases pharyngeal patency in patients with obstructive sleep apnea.
- Hypoglossal nerve stimulation (HNS) is an alternative treatment option for obstructive sleep apnea (OSA) that reduces pharyngeal collapsibility, but HNS nonresponders often demonstrate continued retropalatal and lateral pharyngeal wall collapse. Recent evidence suggests that caudal pharyngeal traction with sternothyroid muscle contraction via ansa cervicalis stimulation (ACS) can also stabilize the pharynx, but the underlying mechanisms have not been elucidated. Our objective was to evaluate the effect of ACS on pharyngeal patency during expiration when the airway is most hypotonic. Eight participants with OSA underwent sustained ultrasound-guided fine-wire stimulation of the medial branch of the right hypoglossal nerve with and without transient stimulation of the branch of the ansa cervicalis nerve plexus innervating the right sternothyroid muscle during drug-induced sleep endoscopy. Airway cross-sectional area and expiratory airflow (V̇e) were measured from endoscopy video with ImageJ and pneumotachometry, respectively. ACS significantly increased retropalatal cross-sectional area (CSARP) to 211% [159-263] of unstimulated CSARP (P < 0.05). Adding ACS to HNS increased CSARP from baseline by 341% [244-439] (P < 0.05), a 180% [133-227] increase over isolated HNS (P < 0.05). ACS increased V̇e from baseline by 177% [138-217] P < 0.05). Adding ACS to HNS increased V̇e by 254% [207-301], reflecting decreases in pharyngeal collapsibility. Combining ACS with HNS increased retropalatal cross-sectional area and increased expiratory airflow, suggesting decreases in pharyngeal collapsibility. Our findings suggest that ACS exerts caudal traction on the upper airway through sternothyroid muscle contraction and that it may augment HNS efficacy in patients with OSA.NEW & NOTEWORTHY Ansa cervicalis stimulation (ACS) is a recently proposed neurostimulation mechanism for generating caudal pharyngeal traction that may benefit patients with obstructive sleep apnea. Here, we document endoscopic findings with ACS during drug-induced sleep endoscopy and additionally detail the effects of ACS on expiratory airflow, when the pharynx is known to be most hypotonic.
=>趣旨, 結果, 影響, 効力, 活動, 印象, 効果, 成し遂げる
Overview of noun effect
The noun effect has 6 senses (first 5 from tagged texts)
1. (101) consequence, effect, outcome, result, event, issue, upshot -- (a phenomenon that follows
and is caused by some previous phenomenon; "the magnetic effect was greater when the rod was
lengthwise"; "his decision had depressing consequences for business"; "he acted very wise after the
event")
2. (11) impression, effect -- (an outward appearance; "he made a good impression"; "I wanted to
create an impression of success"; "she retained that bold effect in her reproductions of the
original painting")
3. (9) effect -- (an impression (especially one that is artificial or contrived); "he just did it
for effect")
4. (2) effect, essence, burden, core, gist -- (the central meaning or theme of a speech or literary
work)
5. (1) effect, force -- ((of a law) having legal validity; "the law is still in effect")
6. effect -- (a symptom caused by an illness or a drug; "the effects of sleep loss"; "the effect of
the anesthetic")
Overview of verb effect
The verb effect has 2 senses (first 2 from tagged texts)
1. (17) effect, effectuate, set up -- (produce; "The scientists set up a shock wave")
2. (3) effect -- (act so as to bring into existence; "effect a change")
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