If snoring is causing breathing pauses and other types of treatment are unsuccessful, an implanted tongue pacemaker can help. The Department of Otorhinolaryngology, Head and Neck Surgery (ORL) now offers this treatment option. A patient was the first to receive a tongue pacemaker at USZ in late March. It was implanted by Lorenz Epprecht, a senior consultant at ORL, and his team.
Snoring itself is not dangerous. But it does become a health risk if the snoring is causing breathing pauses during sleep; this is what doctors refer to as sleep apnea. These breathing pauses can lead to oxygen deficiency and increase the risk of high blood pressure. The latter also increases the likelihood of arteriosclerosis, as well as strokes and heart attacks. Arrhythmia is also associated with sleep apnea.
Treatment options for sleep apnea
An individually adjusted snoring splint to keep the jaw in a stable position is usually all that’s needed for the treatment of mild sleep apnea in most men and women. In more severe cases, special masks worn over the face called CPAP masks can help to support regular breathing during sleep by providing air flow. “This is effective, but the mask really bothers people while they are sleeping,” explains Lorenz Epprecht. Patients who are not suited for other forms of treatment or for whom the treatments have not been successful, now have another option for improving their breathing while they are sleeping: the tongue pacemaker.
How the tongue pacemaker works
The tongue pacemaker is implanted beneath the skin under the clavicle in an operation that lasts about two hours. The device has a stimulating electrode and a cable that is attached to a nerve under the jaw. This nerve leads to the tongue and it sends a weak electrical signal during inhalation. This stimulation moves the tongue slightly forward, allowing for more space in the back part of the mouth. This returns breathing to normal during sleep. Because the tongue relaxes again during exhalation, this procedure is repeated with each inhalation. To avoid interference from these signals during the day, the pacemaker can simply be activated with a remote control before going to sleep and then deactivated again after waking. The operation is performed with a general anesthetic, and a brief stay at the hospital is necessary. “Patients feel well again after two nights in the hospital”, says Lorenz Epprecht.