Development of a standardized evaluation of endobuccal adverse events induced by repeated tongue protrusion with both a dedicated questionnaire and an endobuccal examination
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.
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.
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.
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.
KeywordsSleep medicine Obstructive sleep apnea Upper airway stimulation (UAS) Oral cavity Quality of life Tongue adverse event Satisfaction Questionnaire
Upper airway stimulation
Body Mass Index
Apnea Hypopnea Index
Obstructive sleep apnea
Continuous positive airway pressure
Implantable pulse generator
Stimulation treatment for apnea reduction
Tongue Adverse Event and Satisfaction Questionnaire
Client Satisfaction Questionnaire 8
Drug-induced sleep endoscopy
This study was possible through a COPSIT grant from the University Hospital of Bordeaux.
Compliance with ethical standards
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 was obtained from all individual participants included in the study.
- 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)
- 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
- 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) Google Scholar
- 21.Auriol M-M, Le Naour G (2004) La muqueuse buccale: structure, fonction et examen. Actual Odonto-stomatol 225:7–21Google Scholar
- 22.Bercy P, Tenenbaum HP (1996) Parodontologie: du diagnostic à la pratique. De Boeck & Larder, Bruxelles, pp 1–289Google Scholar