Discussion
This radiograph shows a hypoglossal nerve stimulator. The generator pack projects over the right hemithorax. There are two leads. The first courses superiorly and stimulates the hypoglossal nerve. The second connects to a capsule that is implanted in the chest wall, seen just lateral to the pins on this radiograph. The device stimulates the hypoglossal nerve in concert with the patient’s breathing to prevent sleep apnea. This device is sold under the trade name Inspire®.
Incidentally, this patient also had a prior anterior cervical discectomy and fusion (ACDF), with the plate and screws projecting over the lower cervical spine.