DR. EUGENE CHIO: The hypoglossal nerve stimulator
is basically a pacemaker for the nerve to your tongue. Like any pacemaker, there’s an
implantable device, so that goes in the right upper chest. There’s another incision that’s
made underneath the chin where the electrode is wrapped around the nerve that goes to the
tongue, and that electrode is tunneled underneath the skin and hooked up to the pacemaker that’s
in the chest. And then, a third and separate incision is made underneath the armpit in
the right rib area. There’s a separate sensing electrode that goes between the ribs that
senses your respiratory effort, or drive. So, once you’re asleep, the pacemaker is turned
on by an external device — so you have a remote control that you can basically hold
over the pacemaker to turn it on. You can adjust the time that it takes for the pacemaker
to turn on, anywhere between, say 30 minutes and 45 minutes, to allow you to fall asleep.
And that’s adjustable — once you’re asleep, the pacemaker then kicks on, it measures your
respiratory effort through the electrode in the ribs and then it sends a small burst of
electricity to the nerve that goes to your tongue that tenses up the tongue and prevents
the airway from collapsing at nighttime.