Hypoglossal Nerve Implant Instructions

Important information about the hypoglossal nerve implant: 

The hypoglossal nerve implant is a surgically implanted device used as an alternative sleep apnea treatment. 

 Implant device size compared to a quarter

Implant device size compared to a quarter

  • It is authorized for use in children with Down syndrome (trisomy 21), ages 13 to 18 years old. 

  • Children with moderate obstructive sleep apnea who are unable to tolerate a traditional CPAP (continuous positive airway pressure) machine may be eligible. 

  • The device monitors your child's breathing at night. It stimulates the tongue to move forward, allowing the airway to remain open while sleeping. 

  • The implant is turned on when your child falls asleep at night and turned off in the morning when awake. It is controlled by a remote control.

Important information about the surgery:

  • The surgery will require an overnight stay in the hospital. Your child can go home the next day. 

  • The procedure is done under general anesthesia. Your child will be completely asleep and will not feel any pain or be aware during the procedure. 

  • While your child is asleep, the surgeon will make 2 incisions, one on the right side of the neck just under the jawline. The second incision is on the upper right portion of the chest, where the implant will be placed. 

  • We will monitor your child’s tongue nerves during the procedure. Small electrodes are placed in tongue muscles within the mouth to safely monitor the nerves. 

  • When the procedure is finished, the surgeon will place a pressure dressing on the chest. This dressing will be removed before leaving the hospital. 

  • The incisions are closed with absorbable sutures and surgical tape on top. The surgical tape will fall off on its own in the next few days to weeks. 

  • The device will remain off until your child’s activation appointment to allow for healing. 

Instructions for care at home after surgery: 

Pain and discomfort 

  • Your child may have some mild to moderate pain and swelling at the incision sites. 

  • This should go away in about 7 to 10 days. 

  • Give the prescribed pain medicines as ordered by your surgeon. 

  • Unless instructed otherwise by your surgeon, your child will take celecoxib (Celebrex®) for pain following hypoglossal nerve implant surgery.

  • Celecoxib is a safe and effective non-steroidal anti-inflammatory drug (NSAID) like ibuprofen (Motrin®). It is given 2 times a day, often along with other pain relievers such as acetaminophen (Tylenol®).

Bathing

  • Your child may shower 24 hours after the procedure. 

  • Do not let the incisions soak or be submerged in water. You may let soapy water run over the incisions and surgical tape.

  • No swimming or baths until your child’s follow-up appointment.

  • Do not rub at the incisions

Activity: 

  • Avoid heavy lifting or strenuous activity for 2 weeks or until cleared by your surgeon. 

Follow-up appointment

A follow up appointment will be scheduled for your child 1 week after surgery.

Call your CHOP ENT team with questions, concerns or if:

  • Your child has a fever of 102°F (38.8°C) or higher

  • Your child has continued vomiting at home (2 or more times in one day)

  • Your child’s pain medicine is not relieving their pain

  • You notice a lot of bleeding or drainage from your child’s incision sites

  • There is increased pain, swelling, or foul-smelling odor around the incisions

Division of Otolaryngology (Ear, Nose and Throat)

215-590-3440

7 days per week/24 hours

 

Reviewed February 2024 by Ashley B. Williams, MSN, CRNP-PC, CORLN