Hyoid suspension surgery with UPPP for the treatment of hypopharyngeal airway obstruction in obstructive sleep apnea

August 10, 2012
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Abstract

We report our experience with hyoid suspension surgery in patients with obstructive sleep apnea (OSA) diagnosed on the basis of polysomnographic criteria. We conducted a prospective, observational study of 20 patients—18 males and 2 females, aged 15 to 52 years (mean: 42.1)—who were treated at our tertiary care center. All patients underwent hyoid suspension surgery and uvulopalatopharyngoplasty (UPPP) in a single session. Postoperative success was defined as either (1) a reduction in the apnea-hypopnea index (AHI) from 20 or higher to less than 20 or (2) a reduction in AHI of at least 50%. Postoperative follow-up polysomnography indicated that surgery was successful in 18 of 20 patients (90%). No important complications were observed. We conclude that hyoid suspension surgery is an effective procedure with low morbidity for the treatment of OSA in selected patients with hypopharyngeal obstruction. We believe it is a good option for those patients who will not or cannot tolerate therapy with continuous positive airway pressure.

Introduction

Obstructive sleep apnea (OSA) is clinically defined by frequent episodes of apnea and hypopnea during sleep. OSA is a serious disorder that has been implicated in extreme daytime hypersomnolence, functional impairment, and automobile accidents.1-3It is also associated with cardiovascular morbidity and mortality secondary to hypertension, congestive heart failure, cardiac arrhythmia, myocardial infarction, and cerebrovascular disease.1-3

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