Postoperative radiologic position control after implantation for bilateral hypoglossal stimulation

Background: The implantation of hypoglossal stimulation systems is increasingly recognized as a routine procedure for treating obstructive sleep apnea when indicated. Analogous to the method for other implants (plate osteosynthesis, cochlear implants, etc.), performing a radiological positional control is recommended. This recommendation is based on quality control considerations and as a reference point for postoperative functional changes. This study aimed to evaluate the postoperative position control after treatment with a system for bilateral hypoglossal stimulation.

Methods: On the postoperative day, ten patients underwent radiographic control of the position of a Genio system. Mouth floor radiographs were taken in frontal and sagittal positions, and CT scans were taken in axial and coronal sectional planes.

Results: The radiograph showed a high position variability in the sagittal view about paddle symmetry/height and parallelism to the hyoid bone/chin line. In the frontal view, there was a high variability about the paddle angle and an asymmetry of the position. The CT showed artifacts in both planes.

Conclusion: The postoperative position control after implantation for bilateral hypoglossal stimulation demonstrates the anatomical and operative variability of the system's positioning. Implant-related artifacts must be taken into account for different clinical issues. Postoperative radiological control is necessary and should be seen as a reference point for possible future stimulation changes to rule out postoperative changes in position.

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