Hypoglossal nerve stimulation implant surgery is an outpatient procedure done under general anesthesia. It typically takes two to three hours.
To implant the Inspire device, the surgeon will make an incision under your jaw to wrap the stimulation electrode around the hypoglossal nerve, then a second incision in your chest to place the breathing sensor and pulse generator. A wire is tunneled under the skin to connect the parts.
The Genio procedure requires a single incision under your chin to implant the nerve stimulator.
Neither device is activated immediately after the procedure. For Inspire, you’ll typically wait six weeks to allow the implant site and surrounding nerve to heal, Verma says. For Genio, you’ll wait eight weeks.
The Inspire device is usually activated in the sleep medicine physician’s office. “We slowly introduce a very minimal voltage and see what the patient’s reaction is. Are they sensing it? Then we slowly advance the settings until the patient can feel it,” Verma says. You’ll use that setting as a baseline and gradually increase the voltage by one setting per week.
If the next week’s setting feels too intense — you may feel your tongue is being pulled too hard — Verma advises staying at the lower setting for a couple more days before trying again. “It’s like training a muscle in the gym,” she says. “The more you lift a weight, the more you get used to it.”
It takes approximately six to eight weeks from the date of activation for people to reach their final setting, though some people may need three or four months, she adds.
Similarly, the Genio is activated and fine-tuned by specially trained technicians in consultation with your doctor, although you can make some adjustments yourself using an app.
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