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mild stimulation to the hypoglossal nerve (the primary nerve controlling the tongue) via a generator implanted in the chest to restore tone to key airway muscles and prevent airway collapse. UH is the first and, at this time, the only medical center in Northeast Ohio to offer this treatment. "This is a 'rescue' therapy for patients who have moderate to severe sleep apnea and cannot tolerate CPAP or dental devices, for whatever reason," says Diana Ponsky, MD. Dr. Ponsky is the second of two otolaryngologists at UH to be specially trained to implant the Inspire system. Dr. Jonathan Baskin, who also serves the Louis Stokes VA Medical Center, was the first — during a clinical trial of the Inspire system at UH. The system consists of three compo- nents: a lead implanted in the neck area which attaches to the hypoglossal nerve, a breathing sensor which attaches to the diaphragm, and a neurostimulator or pacemaker that goes in the chest area. The patient controls the system with a small handheld programmer. "This is a very exciting new therapy. Many devices, as well as surgical pro- cedures, have tried to help people with sleep apnea but their success has been so limited. Inspire is the one thing that has really shown promise. It significantly improves quality of life. Essentially, all patients benefit as long as they are appropriately selected," says Dr. Ponsky. The STAR Trial Dr. Ponsky's enthusiasm for the Inspire system is based largely on the results of the recently published Stimulation Therapy for Apnea Reduction (STAR) Trial, a clinical study of the device for which Dr. Strohl served as senior investigator. The multicenter study included 126 participants (seven from UH) who received the implanted system for moderate to severe OSA. To qualify, patients had to have a certain range of problems during sleep (based on the results of a sleep endoscopy study) and could not have a BMI greater than 32. One year after implantation, patients in the study showed a significant reduc- tion in the Apnea Hypopnea Index (AHI) and the Oxygen Desaturation Index (ODI), two measurements of OSA sever- ity. Seventy percent of study participants met the pre-specified targets for FDA approval of Inspire. Now, close to a yea r a f ter those STAR trial results were published in the New England Journal of Medicine, Dr. Strohl says the reaction of the seven local patients who participated in the trial, and have used the device for more than two years now, remains overwhelmingly positive. Diana Ponsky, MD, is currently one of two UH otolaryngologist specially trained to implant the Inspire system. PHOTO © SMITHBERGER PHOTOGRAPHY, NORTH CANTON TECHNOLOGY FE AT UR E 1 4 | Cleveland/Akron/Canton MD NEWS ■ M D N E W S . CO M ■ N OV E M B E R / D E C E M B E R 2 0 1 4