الفهرس 
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Abstract
The present study included 16 adults of OSA patients presented to the Otolaryngology, Rheumatology and rehabilitation Departments in the Suez Canal University Hospital. Exclusion criteria included previous significant facial trauma, head or neck cancer, previous surgery (including tonsillectomy or adenoidectomy), previous radiation therapy to head or neck, known diagnosis of peripheral neuropathy, any implanted device (nerve stimulator, implanted pump, pacemaker and defibrillator), and known pregnancy.
All patients were subjected to assessment protocol that included; thorough history taking (age, sex, snoring, nasal obstruction and excessive daytime sleepiness), clinical examinations (BMI, AHI, FTP and Mallampati grading) and electrophysiological studies of hypoglossal nerve before and after TENS.
The mean age of the patients was 42.6±10.5 years with the range of 28-57 years. 50% of the patients were below the age of forty years and 50% of them above that age. . The mean BMI of the studied patients was 32.8±3.4 kg/m2 with a range of 24-37 kg/m2. Male and female frequencies were equal (50% for both genders) with a ratio of 1:1.
The patients had nasal obstruction (62.6%); 18.8% had unilateral obstruction and 43.7% had bilateral obstruction. The patients had daily snoring (81.2%), while 18.8% of them had positional snoring.
Most of the patients had moderate to severe AHI (15->30) with a prevalence of 87.5%. The mean AHI of the patients was 27.1±8.98 with the range of 10-40. The degree of excessive daytime sleepiness was slight in 18.8% of the patients, mild in 50% of the patients and moderate in 31.3% of the patients. FTP grades were ranged from grade II (FTP II) (37.5%) to grade III (FTP III) (62.5%). Mallampati grading of tonsils were also ranged from grade 2 (T2) (43.8%) to grade 3 (T3) (56.2%).
Most of the patients had delayed distal latency of hypoglossal nerve (75% of the patients in right and left hypoglossal nerves). The mean left distal latency of the patients was 3.24±1.23 ms with the range of 2.5-7.7 ms, while the mean right distal latency of the patients was 3.02±0.61 ms with the range of 2.4-4.6 ms. all the patients had low motor amplitude of hypoglossal nerve (100% of the patients in right and left hypoglossal nerves). The mean left motor amplitude of the patients was 1.68±0.61 mV with the range of 0.6-2.5 mV, while the mean right motor amplitude of the patients was 1.52±0.79 mV with the range of 0.6-3.2 mV.
There were significant positive correlations between excessive daytime sleepiness and BMI, snoring, FTP, Mallampati grading and right distal latency. There were significant positive correlations between AHI and age and BMI. There were significant positive correlations between FTP and age, BMI, snoring, excessive daytime sleepiness and Mallampati grading. There were significant positive correlations between Mallampati grading and age, BMI, snoring, AHI, excessive daytime sleepiness, FTP, right distal latency and right amplitude.
. The frequency of patients with delayed distal latency of hypoglossal nerve were decreased after TENS therapy (50% of the patients in left and 37.5% in right hypoglossal nerves). The mean left distal latency of the patients was 2.1±0.62 ms with the range of 2.3-4.9 ms, while the mean right distal latency of the patients was 2.619±0.286 ms with the range of 2.3-3.2 ms. All the patients had low motor amplitude of hypoglossal nerve (100% of the patients in right and left hypoglossal nerves). The mean left motor amplitude of the patients was 1.7±0.575 mV, while the mean right motor amplitude of the patients was 1.65±0.478 mV.
The mean left distal latency of the patients was decreased significantly after TENS therapy than before therapy (2.1±0.62 ms versus 3.24±1.23 ms, respectively). The mean right distal latency of the patients was also decreased significantly after TENS therapy than before therapy (2.619±0.286 ms versus 3.02±0.61 ms, respectively).
The mean left motor amplitude of the patients didn’t change significantly after TENS therapy than before therapy (1.7±0.575 mV versus 1.68±0.61, respectively), also the mean right motor amplitude of the patients didn’t change significantly after TENS therapy than before therapy (1.65±0.478 mV versus 1.52±0.79 mV, respectively).
The conclusions:
• Most of the patients (75%) had delayed distal latency and all the patients (100%) had low motor amplitude of hypoglossal nerve.
• The mean left and right distal latency of the patients was decreased significantly after TENS therapy than before therapy.
• The mean left and right motor amplitude of the patients didn’t change significantly after TENS therapy than before therapy.