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Mary Talley Bowden, MD; Eric J. Kezirian, MD, MPH; David Utley, MD; Richard L. Goode, MD

Arch Otolaryngol Head Neck Surg. 2005;131:440-445.

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.

Author Affiliations: Memorial Northwest Otolaryngology Head & Neck Surgery Associates, Houston, Tex (Dr Bowden); Departments of Otolaryngology–Head and Neck Surgery, University of California, San Francisco School of Medicine, San Francisco (Dr Kezirian); Department of Veterans Affairs, Otolaryngology–Head and Neck Surgery, Palo Alto Health Care System, Palo Alto, Calif (Drs Utley and Goode); and Stanford University School of Medicine, Stanford, Calif (Dr Goode).

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