Oral and Maxillofacial Surgery Cases (Jun 2024)

Twiddler's syndrome and INSPIRE hypoglossal nerve stimulator malfunction

  • Jennifer W. Bergstrom,
  • Allen Cheng,
  • Baber Khatib,
  • Ashish Patel

Journal volume & issue
Vol. 10, no. 2
p. 100353

Abstract

Read online

Obstructive sleep apnea (OSA) is characterized by recurrent upper airway collapse during sleep. Since FDA approval in 2014, INSPIRE hypoglossal nerve stimulators have been used for the treatment of moderate to severe OSA in patients who are unable to use CPAP. In this case report we discuss malfunction of a hypoglossal nerve stimulator due to rotational manipulation of the implanted device that is patient generated. This phenomenon is called Twiddler's Syndrome and has been demonstrated with other implantable medical devices. We review risk factors associated with Twiddler's syndrome, and strategies for mitigating risk of occurrence.

Keywords