Safety of Monopolar Electrocautery Use in Patients With Implanted Hypoglossal Nerve Stimulators

ABSTRACT Objectives Monopolar electrocautery (MPE) is traditionally avoided in patients with implanted hardware due to concerns about electromagnetic interference. While MPE use in cardiac, spinal cord, and cochlear implants has been documented, no study exists on its impact on hypoglossal nerve stimulators (HGNS). Here we evaluate the impact of MPE use in patients with HGNS implants. Methods This is a retrospective review of 85 consecutive HGNS cases at a tertiary academic center from October 2012 to October 2023. Post‐HGNS implantation surgical procedures were categorized into surgeries with MPE ( n = 38) and without MPE ( n = 47). Data on demographics, polysomnography, and device outcomes were analyzed using descriptive statistics, Wilcoxon signed‐rank tests, and chi‐squared tests. Results Of the 85 patients, 38 (45%) underwent MPE‐involved surgeries, with 7 (18%) head and neck, 20 (53%) torso and upper extremities, and 11 (29%) below the torso. No significant difference in outcomes was found between surgeries above or below the torso ( p = 0.478). Up to 1 month post‐MPE exposure, no device failure or malfunction occurred. Among 11 patients with sleep studies before and after MPE exposure, there was no significant difference in AHI ( p = 1.00). Conclusion This is the first study to assess the safety of MPE in patients with HGNS implants, suggesting that MPE use outside the immediate vicinity of HGNS implants is safe and does not compromise HGNS function. Level of Evidence 3.