Hypoglossal nerve stimulator on extraoral radiography and cone beam computed tomography scan: Case report

Cranio. 2023 Mar 22:1-4. doi: 10.1080/08869634.2023.2188849. Online ahead of print.

Abstract

Background: The hypoglossal nerve stimulator (HNS) device has been employed in some patients with refractory or unsatisfactory outcomes to chronic obstructive sleep apnea management. The objective of this article is to increase recognition of the radiologic appearances of this device within the head and neck region, as seen on extraoral radiographic and cone beam computed tomography (CBCT) images.

Clinical presentation: A 55-year-old man, refractory to a multitude of apneic medical therapies, underwent a series of preorthognathic radiologic studies. Notably, an implanted HNS lead and ribbon electrodes appeared as hyperdense structures on the panoramic radiograph, lateral cephalogram, and CBCT scan.

Conclusion: This article provides various radiologic views of the primary components of an HNS. Clinicians should be able to recognize the presence of neurostimulator devices used for management of chronic sleep apnea within the radiologic field of view of examinations of the head and neck.

Keywords: Case report; cone beam computed tomography scan; hypoglossal nerve stimulator; panoramic radiography.