Hypoglossal Nerve Stimulator Placement
Medically reviewed by Drugs.com. Last updated on Jun 30, 2025.
What do I need to know about hypoglossal nerve stimulator (HNS) placement?
A HNS is a device used to help manage obstructive sleep apnea. The hypoglossal nerve controls the tongue muscles. A HNS helps improve breathing during sleep.
How does HNS work?
The HNS is placed under your skin in your upper right chest during surgery. The device sends a small amount of electrical current to the hypoglossal nerve. This causes the tongue to move forward to keep your airway open. The device is turned on 4 weeks after surgery to give the surgery areas time to heal. The device has the following parts:
- A stimulation electrode cuff is placed around the hypoglossal nerve and connected to a pulse generator.
- A breathing sensor is implanted near your ribs. The sensor is also connected to the pulse generator.
- A pulse generator is implanted on the upper chest under your collarbone. It is about the size of a large watch face and produces electrical signals. The pulse generator is powered by a battery that usually lasts about 11 years.
- A remote control is used to switch the pulse generator on and off. It is also used to control how strong the electrical impulses are.
How do I prepare for HNS placement?
- Your surgeon will tell you how to prepare. Your surgeon may tell you not to eat or drink anything after midnight on the day of your surgery. Arrange to have someone drive you home when you are discharged.
- Tell your surgeon about all medicines you currently take. Your surgeon will tell you if you need to stop any medicine for the surgery, and when to stop. Your surgeon will tell you which medicines to take or not take on the day of the surgery. Tell your surgeon if you have a blood disorder or ever had a bleeding problem.
What will happen during HNS placement?
- You will be given general anesthesia to keep you asleep and free from pain during your surgery. Your surgeon will make 2 small incisions:
- The first will be made in the skin under your jaw. An electrical stimulation cuff will be placed around the hypoglossal nerve. Stitches will hold the electrodes in place.
- The second will be made on the chest wall under your right collarbone. Your surgeon will create a pocket under your skin. The pulse generator device will be placed in the pocket.
- A tunnel will be created under your skin to connect the 2 parts with wires. Your surgeon will do an electrical test to make sure the device triggers the correct tongue movements. An x-ray will be used to check that all the parts are in the correct place.
- All incisions will be closed with stitches and covered with bandages.
What should I expect after HNS placement?
You will be taken to a room to rest until you are fully awake. Healthcare providers will monitor your heartbeat, blood pressure, and incision sites. Do not get out of bed until your healthcare provider says it is okay. Your provider will tell you when you can go home.
- Medicines may be given for pain or to prevent a bacterial infection.
- The HNS device will be turned on when you see your surgeon for a follow-up visit. The impulses can be set to cycle at different levels, times, and strengths. The impulses usually start at a low level and can be increased gradually, if needed. You may have symptoms when the impulses are happening. These may include tingling or discomfort in your neck, upper chest, head, or tongue. You will receive a hand-held remote control. This can be used to start or increase the impulse and turn the device on and off. Your provider will show you how to use the remote.
What are the risks of HNS placement?
The HNS may not work correctly, and you may need to have a part of the device replaced. You may get an infection or have pain, bruising, or swelling at any of the incision sites. You may weakness of the corner of your mouth, tongue weakness or problems moving your tongue. You may have discomfort, pain, or feel a shock during stimulation. On rare occasions you may have a collapsed lung.
Care Agreement
You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.© Copyright Merative 2025 Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.