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Updated: Feb 22, 2026

In Vivo Evaluation of the Mechanical and Viscoelastic Properties of the Rat Tongue
Published on: July 6, 2017
Surgical anatomy of the hypoglossal nerve: A new classification system for selective upper airway stimulation
Clemens Heiser1, Andreas Knopf1, Benedikt Hofauer1
1Department of Otorhinolaryngology, Head and Neck Surgery, Technische Universität München, Munich, Germany.
Background:
Selective upper airway stimulation (UAS) has shown effectiveness in treating patients with obstructive sleep apnea (OSA). The terminating branches of the hypoglossal nerve show a wide complexity, requiring careful discernment of a functional breakpoint between branches for inclusion and exclusion from the stimulation cuff electrode. The purpose of this study was to describe and categorize the topographic phenotypes of these branches.
Methods:
Thirty patients who received an implant with selective UAS from July 2015 to June 2016 were included. All implantations were recorded using a microscope and resultant tongue motions were captured perioperatively for comparison.
Results:
Eight different variations of the branches were encountered and described, both in a tabular numeric fashion and in pictorial schema.
Conclusion:
The examinations showed the complex phenotypic surgical anatomy of the hypoglossal nerve. A schematic classification system has been developed to help surgeons identify the optimal location for cuff placement in UAS.
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