Development of a standardized evaluation of endobuccal adverse events induced by repeated tongue protrusion with both a dedicated questionnaire and an endobuccal examination

  • Cécile Catella
  • Jean-Arthur Micoulaud-FranchiEmail author
  • Pierre-Jean Monteyrol
  • Emmanuel Cuny
  • Olivier M. Vanderveken
  • Emmanuel d’Incau
  • Pierre Philip
Short Communication



A new approach to treat obstructive sleep apnea (OSA) is upper airway stimulation therapy (UAS). Electrical pulses applied to the hypoglossal nerve induce tongue protrusion, increase airway patency and decrease the frequency of apneic and hypopneic events. Thus, the main objective of this study was to design a standardized evaluation of endobuccal adverse events induced by repeated tongue protrusion with both a dedicated questionnaire and an endobuccal examination.


This study has designed the Tongue Adverse Event and Satisfaction Questionnaire (TAESQ) and an endobuccal examinations divided into an endobuccal lesion examination (ELE) and an endobuccal risk factor examination (ERFE). Evaluations were conducted at month 6 post-implantation.


The study population after implantation of UAS device consisted of ten Caucasian males with a mean age of 51.9 ± 11.8 years, and a mean BMI of 28.6 ± 3.3. The AHI of the ten participants ranged from 46.7 ± 12.2/h at baseline to 14.5 ± 8.9/h with the Inspire therapy at the 6-month follow-up. The TAESQ revealed pain (30%), followed by less tongue sensitivity (20%) and tongue weakness (10%). The ELE did not reveal any lesions. The ERFE revealed that some participants had tissue and dental risk factors but not associated to more adverse events.


The TAESQ, ELE and ERFE have been designed and studied on a small number of participants. These evaluations could systematically be included in the care pathway of patients treated by UAS to better investigate tongue discomfort and tongue lesion for patients treated with this technology.


Sleep medicine Obstructive sleep apnea Upper airway stimulation (UAS) Oral cavity Quality of life Tongue adverse event Satisfaction Questionnaire 



Upper airway stimulation


Body Mass Index


Apnea Hypopnea Index


Obstructive sleep apnea


Continuous positive airway pressure


Implantable pulse generator


Hypoglossal nerve


Stimulation treatment for apnea reduction


Tongue Adverse Event and Satisfaction Questionnaire


Client Satisfaction Questionnaire 8


Drug-induced sleep endoscopy



This study was possible through a COPSIT grant from the University Hospital of Bordeaux.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.UFR des Sciences OdontologiquesUniversité de BordeauxBordeauxFrance
  2. 2.Clinique du SommeilCHU PellegrinBordeauxFrance
  3. 3.Univ. Bordeaux, SANPSY, USR 3413BordeauxFrance
  4. 4.CNRS-SANPSY, USR 3413BordeauxFrance
  5. 5.Service de Neuro-chirurgie (E.A., E.C.)CHU de BordeauxBordeauxFrance
  6. 6.Faculty of Medicine and Health SciencesUniversity of AntwerpAntwerpBelgium
  7. 7.Department ENT, Head and Neck SurgeryAntwerp University HospitalAntwerpBelgium
  8. 8.Multidisciplinary Sleep Disorders CenterAntwerp University HospitalAntwerpBelgium
  9. 9.Pôle Odontologie et Santé BuccaleCHU de BordeauxBordeauxFrance

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