NMCSD’s ENTs Perform Novel OSA-Correcting Surgery

Photo By Petty Officer 2nd Class Jacob L. Greenberg | 200902-N-DA693-1093 SAN DIEGO (Sept. 2, 2020) Otolaryngologists (ENTs) assigned to Naval Medical Center San Diego’s (NMCSD) ENT department perform a hypoglossal nerve stimulator implant surgery Sept. 2. Hypoglossal nerve stimulator implant surgery is a novel technique used to treat obtrusive sleep apnea in select patients. NMCSD’s mission is to prepare service members to deploy in support of operational forces, deliver high quality healthcare services and shape the future of military medicine through education, training and research. NMCSD employs more than 6,000 active duty military personnel, civilians, and contractors in Southern California to provide patients with world-class care anytime, anywhere. (U.S. Navy video by Mass Communication Specialist 3rd Class Jake Greenberg)  

SAN DIEGO, CA, UNITED STATES

09.03.2020

Story by Petty Officer 3rd Class Jacob L. Greenberg 

Naval Medical Center San Diego

SAN DIEGO – Otolaryngologists, commonly known as ear, nose and throat specialists (ENTs), assigned to Naval Medical Center San Diego (NMCSD) performed a novel surgery to correct obstructive sleep apnea (OSA) Sept. 2.
A hypoglossal nerve stimulator implant is placed subdermally in the patient’s chest, which sends tiny, electrical impulses to intercostal muscles between the ribs and tongue muscles at night in an effort to mitigate OSA symptoms.
Lt. Cmdr. Art Ambrosio, an ENT and Associate Residency Program Director assigned to NMCSD, said that the mainstay OSA treatment method, the application of positive pressure, using a continuous positive air pressure (C-PAP) machine, is not always effective in patients.
“For pediatric patients who are otherwise healthy, but suffer from OSA, tonsillectomies or adenoidectomies are therapeutic more than 90% of the time,” said Ambrosio. “As these patients reach adulthood, those surgical methods don’t work. Weight gain plays a role, but the anatomy is different. The way the neck muscles and tongue relax are different.”
Ambrosio said that over the last 20 years, there have been different, surgical methodologies to reduce tissue in an effort to prevent airway collapse during sleep.
“The reduction of the soft palate, uvula and tongue hasn’t produced good, long-term results,” said Ambrosio. “[Hypoglossal nerve stimulator implant] surgery doesn’t remove any tissue. It stimulates parts of the body that would normally be relaxed during sleep. In this subset of patients, those who aren’t obese, have no significant heart or psychological problems, we’ve found that this treatment is very effective.”
Hypoglossal nerve stimulator implant surgery is a fairly new treatment.
“I believe that this will be an effective, standard treatment for the targeted patient population, but we can expect to see some limitations for those outside of that,” said Ambrosio. “This treatment can grow in popularity because it’s now only available for adults. There are ongoing, research trials to see the effectiveness [of this treatment] in the pediatrics population that doesn’t respond to tonsillectomies or adenoidectomies.”
Ambrosio remains hopeful that this surgery will continue to change the lives of those suffering from OSA.
“It’s a beacon of hope for those who were told that their only treatment is a C-PAP machine, but don’t respond well to it,” said Ambrosio. “There is a large, segment of OSA-afflicted patients who, even after they’re properly fitted, don’t respond [to C-PAP treatment] with favorable results. OSA is not just affecting their and their family’s quality of life, but their readiness, wakefulness and concentration. Hypoglossal nerve stimulator implants will help that group improve their lives, efficiency, satisfaction and readiness.”
NMCSD’s ENTs have a diverse, surgical skillset. In terms of readiness and deploy-ability, ENTs participate in research for Navy Medicine’s Tactical Combat Casualty Care course. The ENT department also participates in cutting-edge, augmented reality virtual mentorship projects with trauma surgeons, emergency medicine physicians and pulmonary critical care specialists.
NMCSD’s mission is to prepare service members to deploy in support of operational forces, deliver high quality healthcare services and shape the future of military medicine through education, training and research. NMCSD employs more than 6,000 active duty military personnel, civilians and contractors in Southern California to provide patients with world-class care anytime, anywhere.
Visit navy.mil or facebook.com/NMCSD for more information.

• Date Taken: 09.03.2020
• Date Posted: 09.03.2020 17:16
• Story ID: 377430
• Location: SAN DIEGO, CA, US