Sleep apnea, a first surgical procedure carried out at the Nancy CHRU

A first surgical procedure is carried out at the Nancy University Hospital as part of the treatment of sleep apnea. It is the first hospital in France to implant a neurostimulator in a patient. The operation under general anesthesia is reimbursed by Health Insurance.

The surgical procedure was performed for the first time on September 24, 2024 at the Nancy University Hospital (Meurthe-et-Moselle) by Doctor Duc Trung Nguyen. This is a first in France to treat obstructive sleep apnea-hypopnea syndrome (OSAS).

Thursday October 3, 2024, Doctor Duc Trung Nguyen carried out a second intervention. The operation consists of implanting a neurostimulator in the Hypoglossal nerve. It is this nerve that powers the tongue muscles during sleep. The neurostimulator is connected to a probe placed at the level of the rib cage like a pace-maker.

It will detect respiratory movements and transmit the information directly to the stimulator. If breathing is suspended, a stimulus automatically triggers the tongue to move forward, thus freeing the airway.

4% of the population suffers from OSAHS. More commonly known as sleep apnea, the syndrome is manifested by a suspension of breathing several times per night (at least five times). These repeated apneas last ten to thirty seconds and affect the oxygenation of the brain, causing micro-arousals.

The consequences of this disrupted sleep can be serious on a daily basis, explains the surgeon: “drowsiness, memory and concentration problems. The impacts on health are just as worrying: exposure to the risks of cardiovascular disease, hypertension, stroke, heart attack and even the risk of developing diabetes.” Without forgetting that states of drowsiness can lead to accidents in daily life, while driving or in professional activity.

This technique makes it possible to offer a solution to patients who do not tolerate the two common solutions: continuous positive airway pressure (CPAP) and the mandibulatory advancement orthosis. “Studies show that 40% of patients abandon CPAP treatment after four years. It is restrictive, because we have to put on the mask, there are leaks, etc. We then propose the second solution, the orthosis , but it doesn’t always work”, explains Doctor Duc Trung Nguyen. The installation is carried out under general anesthesia and like a pacemaker, the battery must be replaced after 10 years. The doctor works in close collaboration with the sleep medicine and research center and the pulmonology department.

The implantation of a neurostimulator has already been practiced in the United States for several years. It is the decision to reimburse this expensive operation by Health Insurance since August 2024 which now allows its generalization. The Nancy CHRU is the first hospital in France to implement this device.