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Int J Otolaryngol. 2013;2013:263043. doi: 10.1155/2013/263043. Epub 2013 Feb 20.

Thirteen Years of Hyoid Suspension Experience in Multilevel OSAHS Surgery: The Short-Term Results of a Bicentric Study.

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1
Department of Otorhinolaryngology, University of Pavia and IRCCS Policlinico San Matteo Foundation, Viale Camillo Golgi 19, 27100 Pavia, Italy.

Abstract

AIMS:

To evaluate thirteen years of hyoid suspension experience in multilevel OSAHS surgery, for which hyoidthyroidpexia represented the exclusive hypopharyngeal approach applied.

MATERIALS AND METHODS:

From 1998 to 2011, a bicentric retrospective study was conducted: all adult patients with a diagnosis of OSAHS were enrolled. Specific eligible criteria were established. Pre-/postoperative data concerning ENT and sleep findings were recorded. Recruited subjects were surveilled for a follow-up range from 6 to 18 months.

RESULTS:

A total of 590 hyoid suspensions were evaluated, but only 140 patients met the specific inclusion criteria. A success rate of 67% was obtained. No intraoperative adverse events or major complications occurred. Excessive daytime sleepiness was observed in 28% of nonresponders. Despite the homogeneous candidate anatomy, ENT awake findings changed differently after surgery. Statistical analysis revealed multilevel surgery to be more effective when AHI < 30. Postoperative AHI was statistically not influenced by preoperative BMI.

CONCLUSIONS:

Hyoid suspension in multilevel treatment is effective when short-term results are considered. The necessity of a more valuable anatomic-based diagnostic approach is crucial to guide the patient selection. Long-term followups and randomized prospective trials with case-control series are needed to increase the level of evidence of this surgery.

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