Ryan Nord, MD · Surgical learning
Three parallel pathways: one for each hypoglossal nerve stimulator, Inspire and Genio, and one for barbed reposition pharyngoplasty (BRP), the palate operation. Choose an operation to begin. All three follow the same format: step-by-step lessons from indications to closure, operative teaching media, self-checks, and a printable pre-case review.
Unilateral hypoglossal nerve stimulation
Bilateral hypoglossal nerve stimulation
Barbed reposition pharyngoplasty
Podcast corner
October 13, 2026 · 14 min
Carvalhal G, Mora MMR, Peralta-Jiménez GA, Ayasa L, Barrera V, Advani K, et al. Sleep and Breathing 2026
This meta-analysis of six randomized trials asked whether glucagon-like peptide one (GLP-1) receptor agonist drugs, liraglutide and tirzepatide, reduce the severity of obstructive sleep apnea compared with control. Pooled, the drugs lowered the apnea-hypopnea index by about ten events per hour more than control, but the effect differed sharply by drug, and oxygen measures did not improve significantly. The call is no change to surgical decisions for hypoglossal nerve stimulation or barbed reposition pharyngoplasty, with drug-specific numbers recommended for patient counseling.
October 11, 2026 · 15 min
Tschopp S, Janjic V, Caversaccio M, Borner U, Tschopp K. Laryngoscope Investigative Otolaryngology 2026
A two-center Swiss study asked whether the way the tongue base moves on awake ultrasound during hypoglossal nerve stimulation predicts how much a patient's obstructive sleep apnea improves. In 64 patients with unilateral Inspire implants, no ultrasound measure of tongue movement size, symmetry or shape was significantly associated with the drop in the apnea-hypopnea index, though the confidence intervals were wide. The call is no change in practice, with ultrasound worth watching as a research tool.
October 11, 2026 · 14 min
Kilgue A, Gehl H-B, Abolmaali N, Scholtz L-U, Scherl C, Todt I. Frontiers in Surgery 2026
A single-center case series from Germany examined first-day postoperative x-ray and computed tomography after implantation of the Genio bilateral hypoglossal nerve stimulator in 11 patients. Plain films were free of distortion in every patient, and computed tomography showed metal artifact in every scanned patient, which supports x-ray as the routine check. The study did not measure whether paddle position affects treatment outcome, so the call is no change for unilateral Inspire practice, with a watch for follow-up imaging data.
Educational material for residents and clinicians. The pathways include real operative footage and photographs. They support preparation and discussion; they do not establish operative competence or replace supervised surgical training and the current device instructions. Site privacy notice.
Ryan Nord, MD, has served as a consultant for Inspire Medical Systems. He is a clinical investigator for Nyxoah, the maker of Genio, and a member of the clinical events committee for Nyxoah-sponsored trials. This is his personal educational website. The learning center adapts his teaching materials for resident education; it is not a manufacturer training credential. See the full disclosures for his industry relationships and how to report a content correction.