A 57-Year-Old Man Comes to the Office Due to Unrefreshing

question 58

Multiple Choice

A 57-year-old man comes to the office due to unrefreshing sleep.  He feels tired during the day and occasionally has to nap during his lunch hours.  According to his wife, the patient snores loudly during sleep and frequently gasps for breath.  He also has severe claustrophobia.  Past medical history is significant for hypertension.  The patient takes no sedative medications and is a lifetime nonsmoker.  Blood pressure is 156/94 mm Hg and BMI is 30 kg/m².  Physical examination is significant for a bulky tongue and crowded, narrow oropharynx.  Electrical stimulation of which of the following nerves may improve the pathophysiologic cause of this patient's symptoms?

• A)Hypoglossal
• B)Lingual
• C)Maxillary
• D)Phrenic
• E)Recurrent laryngeal

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