Outcomes of hyoid suspension for the treatment of obstructive sleep apnea

Objective: To examine the efficacy of hyoid myotomy and suspension as a treatment of hypopharyngeal obstruction in obstructive sleep apnea. Design: Prospective, observational study. Setting: Academic medical center. Patients: Twenty-nine consecutive male patients with suspected hypopharyngeal obstruction Interventions: Patients underwent hyoid suspension. Uvulopalatopharyngoplasty with or without tonsillectomy was performed at the same time for those patients who had not undergone this procedure previously. Patients underwent clinical examination and sleep study prior to surgery and approximately 1 year postoperatively. Main Outcome Measures:: Primary outcome was a successful surgical result, defined as apnea-hypopnea index lower than 20, 50% or greater decline in apnea-hypopnea index, and no oxygen desaturations below 85% on the postoperative sleep study. Secondary outcomes included daytime sleepiness as determined by the Epworth Sleepiness Scale and the severity of snoring. Postoperative complications were also recorded. Results: Only 5 (17%) of 29 patients achieved a successful outcome. The respiratory disturbance index did not change significantly for the group as a whole, although the lowest oxygen saturation did show some improvement. Conclusions: Hyoid suspension does not provide results equivalent to those reported for genioglossus advancement or multisession tongue radiofrequency. Hyoid suspension alone is not an efficacious treatment for hypopharyngeal airway obstruction in most patients with obstructive sleep apnea.