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F. Adjust Placement as Needed
To refine placement, small adjustments may be made to the electrode position in the fossa
with respect to the vidian canal and foramen rotundum. Make any needed adjustments by
grasping the Microstimulator body or bone plate to advance or retract the lead in the fossa.
Intraoperative images are taken to confirm final placement of the Microstimulator in the
appropriate location.
G. Attach the Microstimulator
Use the Bone Fixation Plate and at least two 1.8 mm craniomaxillofacial bone screws (not
provided by Autonomic Technologies) to anchor the Microstimulator to the anterior zygomatic
process of the maxilla, which contains thick, dense bone (Figure 16). Care should be taken to
confirm that the distal lead has not entered the inferior orbital fissure or nasal cavity.
NOTE: The Microstimulator should be placed such that the flat portion of the Microstimulator
Body and Bone Fixation Plate are facing the maxillary bone.
NOTE: Confirm the Microstimulator’s distal lead position using fluoroscopy or X-ray.
NOTE: Fix the Microstimulator to thick, dense bone to avoid potential dislodgement.
NOTE: Take care to avoid displacement of the Microstimulator while bending the Bone
Fixation Plate.
NOTE: The Bone Fixation Plate can also accept a rescue screw, if needed, of up to 1.8 mm in
diameter.
NOTE: Implant the microstimulator at least 1.2cm from the skin surface to ensure the ability to
use all available power setting during therapy.
Figure 16: Anchoring the Microstimulator
H. Intra-Operative Functionality Testing
To confirm proper Microstimulator functionality, perform an implant impedance test. To do so,
hold the sterile-
sleeved Remote Controller to the Patient’s cheek above the implant or instruct
a Scrub Tech to do so. Next, use the Programming Software to wirelessly connect the Remote
Controller to the Microstimulator (or instruct a Scrub Tech to do so). Select the impedance test
