The hypoglossal nerve stimulator is promising for the treatment of sleep apnea in children with Down syndrome

Christopher Hartnick. In addition, MD, MS, Director of the Pediatric Oto-Rhinourée Division at Mass Eye and Ear, is the senior and correspondent author and Brian Skotko, MPP, MPP, Director of the Down and Emma Campbell Syndrome Program with an article published in Massachusetts syndrome, International newspaper of Pediatric Otorhinolaryngology, “Hypoglossal nerve stimulator for obstructive sleep apnea in children with Down syndrome under the age of 13. Therefore, »»

Q: How would you summarize your study for a profane audience?

Sleep apnea. For example, or difficulty breathing at night, is common in children with Down-Affective syndrome up to 80% against only 5% of the general pediatric population. Meanwhile, Sleep apnea can have a negative impact on the ability of any child to work. Meanwhile, learn, but for children with Down syndrome hypoglossal nerve stimulator promising treatment which have neurocognitive differences, good sleep can be even more crucial for their development. For example, Standard treatments such as the elimination of tonsils. Similarly, adenoids are often less effective for these children due to anatomical differences, including a larger language which can block respiratory tract during sleep.

We have recently demonstrated the safety. Therefore, effectiveness of a hypoglossal-an implant nerve stimulator that acts as a language stimulator by advancing to open the respiratory tract when apnea occurs for patients with Down syndrome between ages of 13 and 21 years. Similarly, These data contributed to the approval of the FDA for this age group.

Since the first school years are a crucial period for development. In addition, our new research aimed to determine whether this treatment is also safe and effective for young children with Down syndrome, which allows them to benefit from key neurocognitive advantages.

Q: On what question hypoglossal nerve stimulator promising treatment did you investigate?

The main questions that our study addressed were around the security and therapy response of the hypoglossal nerve stimulator. Furthermore, Security was evaluated by the number of undesirable events that children have known. Moreover, in particular from surgery and the device itself. We must collect data that shows that the procedure can be carried out safely in a 4 -year -old child who has a different anatomy from that of an adult. adolescent who undergoes surgery, or if there are surgical challenges specific to this age group that prevent success.

Then we needed to know if the treatment was effective. The therapeutic response was defined as a reduction in their obstructive apnee index by 50% or more. Oahi is a measure of the number of apnea events. or the time that a child ceases to breathe, per hour.

Q: What methods or approach have you used?

hypoglossal nerve stimulator promising treatment

Our study was a retrospective review of 29 children aged 4 to 13 who have undergone surgeries of implants of the hypoglossal nerve in two hospitals: Mass Eye. Ear and Phoenix Children’s Hospital. Children who have undergone surgeries had sleep studies before surgery, then at 1 to 3 months, 6 months, 1 year and 3 years after surgery.

Mass. ear patients were treated and monitored as part of a multidisciplinary collaborative team from Mass General Brigham, including clinicians from Massachusetts General Hospital who specialize in Down syndrome and pediatric sleep medicine. Children with Down syndrome have unique care needs and we find this vital multidisciplinary care approach.

Q: What did you find?

We found that the hypoglossal nerve stimulator surgery was safe in the 29 children, without serious unwanted events. A child had a minor unwanted event with surgical healing that has been resolved. There was no adverse event hypoglossal nerve stimulator promising treatment linked to the apparatus itself.

The children of our study showed striking reductions in their sleep apnea events. At 6 months after the operation, more than 95% of children underwent an Oahi reduction by more than 50% or more. Before surgery, the median Oahi was more than 18 apnea events per hour, and after surgery, the median was nearly 4 events. It’s a huge difference.

Q: What are the implications?

This research has major implications. first of all, that security results can mitigate concerns as to this procedure is possible in young children. There had been concerns about whether the security of the implant remains as a child. and following the children for three years, we saw that it remained stable.

Then. depending on these safety and efficiency results, we believe that this research provides data that the FDA can examine to approve the processing of young children.

We hypoglossal nerve stimulator promising treatment also believe that this research offers a message of hope to parents of young children with Down syndrome. who have worried about the sleep apnea of their children.

Q: What are the next steps?

These results will allow our team to submit subsidies to finance trials that answer the question of whether neurocognition improves more for children with Down syndrome. the more they receive treatment.

Following our test in adolescents. young adults, we received a five -year gran of the National Institutes of Health (NIH) to study neurocognition and linguistic results in adolescents over 10 years old with Down syndrome which has undergone surgery. This study ends soon. We want to conduct a similar study in children between 4 and 10 years old.

When we talk to parents of the age of children. adolescents, we often hear positive comments, as if they had no more worried overnight of their child’s hypoglossal nerve stimulator promising treatment breathing, and their child prosperous in school, having less mood swings and behavioral problems, and to speak better than ever. But we need data to support these qualitative reports, and our hope is to receive funding to continue such research.