Publicado Mar 22, 2014



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Irene Camila Pérez García

Juan David Salcedo Betancourt

Elsa Carolina Ríos Rosado

Álvaro J. Ruiz Morales

Juan Camilo Ospina García

Patricia Hidalgo Martínez

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Resumen

Introducción: la apnea obstructiva del sueño (AOS) es el trastorno respiratorio del sueño más frecuente. La terapia de elección es la presión positiva continua de la vía aérea (CPAP), pero se ha descrito mala adherencia en su uso. La estimulación del nervio hipogloso (ENH) se encuentra entre las nuevas modalidades de tratamiento en estudio.

Objetivo: revisar la fisiopatología de este trastorno, así como la efectividad y seguridad de la ENH como terapia de la AOS.

Metodología: se realizó una búsqueda en la base de datos de Medline utilizando las palabras clave: Sleep Apnea, Syndrome; Sleep Apnea, Obstructive; Hypoglossal Nerve; Electrodes, Implanted; Implantable Neurostimulators, y Electric Stimulation Therapy.

Resultados: se encontraron 267 artículos, de los cuales se seleccionaron 27 según los criterios de inclusión y exclusión. Adicionalmente, se hizo una búsqueda secundaria de estos artículos. La ENH ha mostrado un perfil de efectividad y seguridad favorable con alta adherencia como tratamiento de la AOS. Sin embargo, no se recomienda en pacientes con un índice apnea-hipopnea > 50, ya que produce una reducción parcial, inferior que la que puede producir el CPAP.

Conclusiones: la ENH ayuda a corregir, parcialmente, uno de los mecanismos fisiopatológicos de la AOS. Si bien en la revisión se encontraron datos que sugieren efectividad y seguridad aceptables en corto plazo, se necesitan más estudios sobre efectividad y seguridad a largo plazo, sobre comparación directa con CPAP en algunos casos y sobre uso bilateral de esta nueva modalidad terapéutica.

Keywords

apnea del sueño obstructiva, nervio hipogloso, terapia por estimulación eléctrica, Sleep apnea, obstructive, hypoglossal nerve, electric stimulation therapy,

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Cómo citar
Pérez García, I. C., Salcedo Betancourt, J. D., Ríos Rosado, E. C., Ruiz Morales, Álvaro J., Ospina García, J. C., & Hidalgo Martínez, P. (2014). Estimulación del nervio hipogloso: una nueva alternativa en el tratamiento de la apnea obstructiva del sueño. Universitas Medica, 55(3), 286–296. https://doi.org/10.11144/Javeriana.umed55-3.enhn
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