Programming Manual

If the Microstimulator size was not chosen beforehand, then it can be chosen during the

procedure. To do so, estimate the appropriate Microstimulator length by using the centimeter

scale on the medial surface of the Surgical Introducers (Figure 6 and Figure 12) once it is

positioned correctly at the pterygomaxillary fissure or within the PPF (Figure 13). This can be

done by reading the distance from the start of the scale on the proximal portion of the Surgical

Introducer to the posterior-lateral edge of the zygomaticomaxillary buttress, and subtracting the

distance from 6.0 cm. Each solid/clear segment of the Surgical Introducer scale represents 0.5

cm.

EXAMPLE: The distance from the proximal portion of the scale to the buttress is three

solid/clear segments (1.5 cm). The estimated Microstimulator length is then 4.5cm, which is

the equivalent of 6.0cm less 1.5cm (Figure 12). In this example, the physician may choose the

medium size of Microstimulator. The Microstimulator length does not include the integral Bone

Fixation Plate.

The distal tip of the Surgical Introducer, when placed properly, is located at the

pterygomaxillary fissure or just within the pterygopalatine fossa. The Lead Blank is used to

create an implant path beyond the tip of the Surgical Introducer within the pterygopalatine

fossa for the Microstimulator Lead. Surgical Introducers include an Insertion Groove (Figure 6)

along the medial surface. Track the Lead Blank along the Insertion Groove on the Surgical

Introducer (Figure 14). Using gentle pressure, advance the Lead Blank along the Insertion

Groove beyond the distal tip of the Surgical Introducer into the pterygopalatine fossa (Figure

15). The Lead Blank has a spherical tip and a flexible shaft that can be used to create an

implant path within the soft tissue of the pterygopalatine fossa. An inferior to superior implant

path or trajectory (Figure 15), starting at the inferior portion of the PPF and progressing

superiorly and medially within the PPF may be associated with better therapy. Implant

trajectories that are more lateral to medial within the PPF are associated with reduced

outcomes compared to inferior to superior trajectories. The Lead Blank is approximately the

same diameter as the Microstimulator Lead.

Figure 14: Advancing the Lead Blank in the Surgical Introducer Insertion Groove