Lateral Axillary Approach for Placement of the Fifth-Generation Hypoglossal Nerve Stimulator Implantable Pulse Generator.

Hypoglossal nerve stimulation has become an increasingly popular treatment for obstructive sleep apnea. Some patients express concerns about the appearance of the anterior chest incision scar. Here, we describe the feasibility of the lateral axillary approach for placing the fifth-generation implantable pulse generator, which does not require a respiratory sensor. The first three patients were successfully implanted, had excellent respiratory waveforms, and had no complications. The surgical times were not substantially different than for implanting the fourth-generation or fifth-generation device through a standard anterior chest incision.