Hyoid suspension

Surgical procedure to treat obstructive sleep apnea

Overview

Hyoid suspension with base hyoid position

Hyoid suspension is a surgical procedure used primarily to treat obstructive sleep apnea (OSA). This procedure involves repositioning the hyoid bone, a U-shaped bone in the neck, to improve airway patency during sleep. The hyoid bone is suspended to the thyroid cartilage or the mandible to prevent airway collapse.

Indications

Hyoid suspension is indicated for patients with moderate to severe obstructive sleep apnea who have not responded adequately to continuous positive airway pressure (CPAP) therapy or other non-surgical treatments. It is often considered when the obstruction is identified at the level of the tongue base or the hypopharynx.

Procedure

Hyoid suspension with advanced hyoid with ghost of base position

The procedure typically involves making an incision in the neck to access the hyoid bone. The surgeon then mobilizes the hyoid bone and secures it in a more anterior position, often using sutures or a titanium plate. This anterior repositioning helps to open the airway by pulling the tongue base forward and stabilizing the hypopharyngeal airway.

Postoperative Care

After the surgery, patients may experience some discomfort and swelling in the neck. Pain management and monitoring for any signs of infection are important aspects of postoperative care. Patients are usually advised to follow a soft diet and avoid strenuous activities for a few weeks.

Complications

Potential complications of hyoid suspension include infection, bleeding, and damage to surrounding structures such as the laryngeal nerve. There may also be changes in voice or swallowing difficulties, although these are typically temporary.

Outcomes

Hyoid suspension has been shown to be effective in reducing the severity of obstructive sleep apnea in selected patients. Success rates vary, and the procedure is often combined with other surgical interventions, such as uvulopalatopharyngoplasty (UPPP) or genioglossus advancement, to achieve optimal results.

Related pages

• Obstructive sleep apnea
• Continuous positive airway pressure
• Uvulopalatopharyngoplasty
• Genioglossus advancement

Hyoid suspension with advanced hyoid