I’ve just returned from attending the International Surgical Sleep Society (ISSS) meeting held this year in Indianapolis, IN October 9-11. For me, this annual conference is an absolute delight. Many, if not most, of the world’s leading experts on the surgical management of obstructive sleep apnea (OSA) as well as experts from sleep medicine attend and present at the event. I learn so much from listening to their lectures and interacting with them during their presentations and between sessions. There is something else I get from these meetings. There is such excitement and passion at the meeting which invigorates and inspires me to improve my own care of the patient suffering from OSA.
I had the added privilege of being asked to be part of a panel of experts speaking about patient selection for the various treatments of OSA. I was humbled and a bit awed to sit next to Drs. Olivier Vanderveken from the University of Antwerp, Belgium, Christina Baldassari from Eastern Virginia Medical School, and Sandeep Bansai at Postgraduate Institute of Medical education and Research, Chandigarh, India. It was a thrill meeting Dr. Vanderveken in person as he is one of the pioneers of hypoglossal nerve stimulation and has been at the forefront of advancing this therapy around the world.
There is so much exciting technology being developed right now to offer patients in the future more and better treatment options than we have today. This includes upgrades to the technologies we already have like Inspire and Genio by Nyxoah but also technologies which will stimulate new neural targets to further open the airway.
Researchers (including myself) are investigating stimulating other nerves in the neck. One of these nerves (the ansa cervicalis) when stimulated will pull down on the larynx (voicebox) thereby increasing tension in the lateral walls of the pharynx to help reduce inward collapse. Other, even more recent, ideas include stimulating the lesser palatine nerve which sits in the roof of the mouth and supplies the soft palate muscles. Investigators are looking to see if stimulating this nerve may open the soft palate to open the upper part of the throat. They are even looking at stimulating the phrenic nerve which supplies the diaphragm muscle to see if this may also serve to open the upper airway.
I can’t wait to see how all of these play out. It will give us so many more options but also create even more complexity to the decision-making process of choosing the right therapy option for each patient.