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HNO

, Volume 67, Issue 4, pp 242–250 | Cite as

Der terminale N. hypoglossus und seine anatomische Vielfalt

  • C. HeiserEmail author
  • A. Knopf
  • B. Hofauer
Leitthema
  • 68 Downloads

Zusammenfassung

Die obere Atemwegstimulation spielt in der Therapie der obstruktiven Schlafapnoe (OSA) eine immer wichtigere Bedeutung. Ziel der Stimulation ist der N. hypoglossus (N. XII), der als rein motorischer Nerv die Zungenmuskulatur innerviert. Durch die selektive Stimulation einzelner Nervenfasern kann der obere Atemweg mithilfe einer Protrusion der Zunge geöffnet werden. Der N. XII weist eine Vielzahl von anatomischen Varianten auf, die v. a. bei der chirurgischen Implantation dieser Schrittmachersysteme entscheidend sind. Das intraoperative Neuromonitoring ist hier sehr hilfreich. Für die genaue Platzierung der Stimulationselektrode bei der selektiven oberen Atemwegstimulation sind nun die Kenntnisse der Anatomie des N. XII, das intraoperative Neuromonitoring und die genaue Beurteilung von Muskelkontraktionen und Zungenbewegungen von entscheidender Bedeutung.

Schlüsselwörter

Atmungsstörungen Elektrische Stimulation Obstruktive Schlafapnoe Positivdruckbeatmung Kontinuierlicher positiver Atemwegsdruck 

The terminal hypoglossal nerve and its anatomical variability

Abstract

Upper airway stimulation plays an increasingly important role in the treatment of obstructive sleep apnea (OSA). The target of stimulation is the hypoglossal nerve (N. XII), which—as a pure motor nerve—innervates the intrinsic and extrinsic tongue muscles. By selectively stimulating individual nerve fibers, the upper airway can be opened by protruding the tongue. The N. XII has a number of anatomical variants, which are decisive during surgical implantation of these pacemaker systems. Intraoperative neuromonitoring is very helpful in this regard. Accurate placement of the stimulation electrode for selective upper airway stimulation requires knowledge of N. XII anatomy, intraoperative neuromonitoring, and accurate assessment of muscle contractions and tongue movements.

Keywords

Respiration disorders Electric stimulation Obstructive sleep apnea Positive pressure respiration Continuous positive airway pressure 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

C. Heiser ist als Berater für die Fa. Inspire Medical Systems (Maple Grove, USA) tätig. B. Hofauer hat Reisekostenzuschüsse und Vortragsentgelte von der Fa. Inspire Medical Systems (Maple Grove, USA) erhalten. A. Knopf gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  1. 1.Klinik und Poliklinik für Hals-Nasen-OhrenheilkundeKlinikum rechts der Isar, der Technischen Universität MünchenMünchenDeutschland

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