Research Paper
Hyoid myotomy and suspension without simultaneous palate or tongue base surgery for obstructive sleep apnea
World Journal of Otorhinolaryngology-Head and Neck Surgery, 2017,03(02) : 110-114. DOI: 10.3760/cma.j.issn.2095-8811.2017.02.109
Abstract
Objective:

Determine the effects of hyoid myotomy and suspension (HMS) without concurrent palatal or tongue base sleep surgery for obstructive sleep apnea (OSA).

Method:

Patients with OSA treated with HMS were identified using CPT code (21685) at an academic and private sleep surgery clinic. Those who underwent concurrent palatal or tongue base sleep surgery were excluded. Outcomes included simultaneous procedures, apnea-hypopnea index (AHI), lowest oxyhemoglobin saturation (LSAT), and Epworth Sleepiness Scale (ESS).

Results:

Nineteen patients with OSA underwent HMS without palatal or tongue base sleep surgery. The average age at surgery was (55.3 ± 13.5) years with a majority of patients being male (71%). Concurrent procedures included the following: torus mandibularis excision (n = 1), endoscopic sinus surgery (n = 4), septoplasty (n = 10), inferior turbinate reduction (n = 12), and nasal valve repair (n = 2). AHI improved significantly from (39.7 ± 21.2) events/h to (22.6 ± 22.7) events/h after HMS (P < 0.01), which represented a 43% reduction. LSAT significantly increased from (82.2% ± 9.9%) to (86.6% ± 6.2%), P < 0.01. There was no improvement in ESS after surgery (8.2 ± 4.4) to (8.3 ± 5.2), P = 0.904. A subset of patients with severe OSA (AHI > 30 events/h) had an improvement in AHI from (49.9 ± 16.6) events/h to (29.1 ± 24.9) events/h, P < 0.01.

Conclusion:

HMS without palatal or tongue base sleep surgery improves OSA severity. It can be considered as a valid option in the treatment of OSA in appropriately-selected patients.

Cite as: Ong Adrian A., Buttram Jonathan, Nguyen Shaun A., et al.  Hyoid myotomy and suspension without simultaneous palate or tongue base surgery for obstructive sleep apnea [J]. World Journal of Otorhinolaryngology-Head and Neck Surgery,2017,03(02): 110-114. DOI: 10.3760/cma.j.issn.2095-8811.2017.02.109
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Introduction

Obstructive sleep apnea (OSA) is a condition characterized by recurrent partial or complete obstruction of the upper airway during sleep, which affects approximately 2%-4% of middle-aged adults.1 Although the first-line treatment for moderate-to-severe OSA is continuous positive airway pressure (CPAP), long-term compliance is poor and estimated to be as low as 50%.2 Alternatively, upper airway surgery has been proposed as a salvage therapy in order to decrease the repetitive obstructions in those intolerant of CPAP therapy. Multiple surgeries have been introduced including tissue removal or remodeling procedures of the palate and base of tongue to address the different levels of collapse seen in the upper airway.3

 
 
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Keyword
Hyoid myotomy and suspension
AirLift system
obstructive sleep apnea