Computerized Tomography of the Implanted Hypoglossal Nerve Stimulator and Approach to Device Malfunction: A Case Series

Aim: This case series looks at outcomes in 39 patients implanted using the Bioness Stimrouter system on various isolated mononeuropathies. Patients & methods: A case series of 39 patients with a total of 42 implants were enrolled starting August 2017 at various pain management centers. Results: Of 39 patients studied, 78% of the participants noticed an improvement in their pain. There was a 71% reduction in pain scores with the average preprocedure score of 8 improving to 2 post-implant. Participants noted on average a 72% improvement in activity with the greatest observed in the brachial plexus (80%) and suprascapular nerve (80%) and smallest in the intercostal nerve (40%). Approximately 89% of those implanted with a peripheral nerve stimulator experienced a greater than 50% reduction in opioid consumption. Conclusion: Peripheral nerve stimulators are a new, minimally invasive neuromodulation modality that shows promising early results in our 39-patient case series.

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Computerized Tomography-Guided Core-Needle Biopsy of Orbital Space-Occupying Lesions: A Case Series

Ocular Oncology and Pathology ◽

10.1159/000510867 ◽

2020 ◽

pp. 1-8

Author(s):

Bashar M. Bata ◽

Andrew Martin ◽

Daniel Connolly ◽

Hardeep Singh Mudhar ◽

Naomi Hersey ◽

...

Keyword(s):

Computerized Tomography ◽

Neuroendocrine Tumour ◽

Case Series ◽

B Cell Lymphoma ◽

Major Surgery ◽

Open Biopsy ◽

Core Needle ◽

Peribulbar Block ◽

Orbital Space ◽

Mass Lesions

Purpose: To describe our experience in performing biopsy of post-septal orbital masses with core needle under computerized tomography guidance (CT-CNB). Methods: The medical records of all patients who underwent this procedure were reviewed. The procedure was performed under local anesthesia on a day case basis under a peribulbar block. A planning non-contrast computerized tomography (CT) scan of the orbits was performed to localise the mass. A 6-cm 18-G Temno Evolution® semi-automated biopsy needle was inserted through the skin into the orbit. Prior to further advancement of the needle, a low-dose CT limited to the previously determined plane was performed to confirm its position. The needle was then advanced, and the cutting needle was deployed to obtain the biopsy. Results: Five patients who underwent CT-CNB were identified. The CNB was successful in 4 patients and revealed a metastatic prostate adenocarcinoma, diffuse large B-cell lymphoma, a metastatic neuroendocrine tumour, and orbital inflammatory disease. The biopsy failed in the fifth patient when the needle failed to penetrate the tumour despite good localisation on CT. He was eventually diagnosed with fibrous meningioma of the greater wing of sphenoid on open biopsy. None of the patients had any complications other than peri-ocular bruising which was present in all of them. Conclusion: CT-CNB of mass lesions located in the lateral aspect of the orbit can be an alternative to open biopsy in selected cases. It avoids major surgery and allows the use of radiotherapy, if required, without any delay.

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Association between anxiety, depression, and emotional distress and hypoglossal nerve stimulator adherence

Sleep And Breathing ◽

10.1007/s11325-021-02366-4 ◽

2021 ◽

Author(s):

Madelyn E. Rosenthal ◽

M. Melanie Lyons ◽

Jessica Schweller ◽

Vedat O. Yildiz ◽

Eugene G. Chio ◽

...

Keyword(s):

Emotional Distress ◽

Hypoglossal Nerve ◽

Nerve Stimulator ◽

Anxiety Depression

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Hypoglossal nerve stimulator placement in a child with severe refractory OSA: a novel procedure in the paediatric population

BMJ Case Reports ◽

10.1136/bcr-2021-242592 ◽

2021 ◽

Vol 14 (5) ◽

pp. e242592

Author(s):

Clayton D Adams ◽

Srijaya K Reddy ◽

James D Phillips ◽

Brian R Emerson

Keyword(s):

Hypoglossal Nerve ◽

Paediatric Population ◽

Nerve Stimulator

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Hypoglossal Nerve Stimulator: A Novel Treatment Approach for Obstructive Sleep Apnea Overview of Treatment, Including Diagnostic and Patient Criteria, Procedural Terminology Codes

CHEST Journal ◽

10.1016/j.chest.2021.05.039 ◽

2021 ◽

Author(s):

Fauziya Hassan ◽

Neeraj Kaplish

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Hypoglossal Nerve ◽

Treatment Approach ◽

Nerve Stimulator ◽

Novel Treatment ◽

Obstructive Sleep

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Computerized tomography evaluation of a resorbable implant after transforaminal lumbar interbody fusion

Neurosurgical FOCUS ◽

10.3171/foc.2004.16.3.11 ◽

2004 ◽

Vol 16 (3) ◽

pp. 1-6 ◽

Cited By ~ 27

Author(s):

Timothy R. Kuklo ◽

Michael K. Rosner ◽

David W. Polly

Keyword(s):

Computerized Tomography ◽

Interbody Fusion ◽

Case Series ◽

Ct Scanning ◽

Transforaminal Lumbar Interbody Fusion ◽

Delayed Union ◽

Lumbar Interbody Fusion ◽

Disc Space ◽

Screw Breakage

Object Synthetic bioabsorbable implants have recently been introduced in spinal surgery; consequently, the indications, applications, and results are still evolving. The authors used absorbable interbody spacers (Medtronic Sofamor Danek, Memphis, TN) packed with recombinant bone morphogenetic protein (Infuse; Medtronic Sofamor Danek) for single- and multiple-level transforaminal lumbar interbody fusion (TLIF) procedures over a period of 18 months. This is a consecutive case series in which postoperative computerized tomography (CT) scanning was used to assess fusion status. Methods There were 22 patients (17 men, five women; 39 fusion levels) whose mean age was 41.6 years (range 23–70 years) and in whom the mean follow-up duration was 12.4 months (range 6–18 months). Bridging bone was noted as early as the 3-month postoperative CT scan when obtained; solid arthrodesis was routinely noted between 6 and 12 months in 38 (97.4%) of 39 fusion levels. In patients who underwent repeated CT scanning, the fusion mass appeared to increase with time, whereas the disc space height remained stable. Although the results are early (mean 12-month follow-up duration), there was only one noted asymptomatic delayed union/nonunion at L5–S1 in a two-level TLIF with associated screw breakage. There were no infections or complications related to the cages. Conclusions The bioabsorbable cages appear to be a viable alternative to metal interbody spacers, and may be ideally suited to spinal interbody applications because of their progressive load-bearing properties.

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A case series of celiac plexus neurolysis for pain relief under computerized tomography scan guidance by ethanol via anterior approach

Journal of Clinical Medicine Bach Mai Hospital ◽

10.52322/jocmbmh.121.13 ◽

2021 ◽

Vol 121 ◽

Keyword(s):

Pain Relief ◽

Computerized Tomography ◽

Anterior Approach ◽

Case Series ◽

Celiac Plexus ◽

Tomography Scan

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Hypoglossal Nerve Stimulator Implantable Pulse Generator Exchange for Battery Depletion

Otolaryngology ◽

10.1177/0194599820925767 ◽

2020 ◽

Vol 163 (2) ◽

pp. 389-390

Author(s):

Andrew J. Goates ◽

Erik K. St Louis ◽

Michael D. Olson

Keyword(s):

Hypoglossal Nerve ◽

Pulse Generator ◽

Nerve Stimulator ◽

Implantable Pulse Generator

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0674 Association Between Lateral Wall Collapse On Drug-induced Sleep Endoscopy And MRI Findings In Hypoglossal Nerve Stimulator Patients

SLEEP ◽

10.1093/sleep/zsaa056.670 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A257-A257

Author(s):

Y Liu ◽

A Wiemken ◽

A Steffen ◽

R Schwab ◽

R Dedhia

Keyword(s):

Hypoglossal Nerve ◽

Lateral Wall ◽

Inverse Association ◽

Sleep Endoscopy ◽

Nerve Stimulator ◽

Mri Findings ◽

Drug Induced ◽

Drug Induced Sleep Endoscopy ◽

Obstructive Sleep ◽

The Mean

Abstract Introduction Hypoglossal nerve stimulator (HNS) is an effective and safe alternative therapy for obstructive sleep apnea (OSA) in selected patients. Emerging evidence demonstrates that the outcome of HNS is variable, especially for patients with lateral wall collapse on drug-induced sleep endoscopy (DISE). Awake magnetic resonance imaging (MRI) offers detailed visualization of soft tissue. The aim of this study was to determine whether lateral wall collapse on DISE is associated with awake MRI findings in prospective HNS patients. Methods Patients from the ADHERE Registry, an international outcomes study for UAS were used for this study. At baseline, awake, supine MRI scans of each subject’s head and neck region were collected. The distance between the lateral walls was measured at the level of the hard palate, located by the appearance of the posterior nasal spine, using axial T2 turbo spin echo MRI. DISE assessments of the upper airway were recorded using the VOTE classification. All statistical analyses were performed using SPSS IBM 19.0 software program. Kendall’s Tau-b was performed to compare the association between VOTE scoring and MRI findings. Results Twenty-seven patients (N = 3 female, AHI = 28.8±10.5, BMI = 28.8 ±3.8 kg/m2, age = 53±9.9 years) were included in this study. The mean overall VOTE score and lateral wall score was 5.6±1.1 and 0.5±0.5, respectively. The mean lateral wall distance was 18.8±3.2 mm. A significant, inverse association was found between MRI lateral wall measurement and oropharyngeal lateral wall scoring on DISE (T=-.332,p=0.042) but not other anatomic subsites on DISE. Conclusion In our study, greater lateral wall collapse on DISE corresponded to narrower lateral airway distance on MRI. The utility of static imaging modalities such as MRI as patient selection tools for HNS warrants further study. Support Drs. Dedhia and Schwab receive related support for this project from the National Institutes of Health (NHBLI R01HL144859)

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