Hyoidthyroidpexia: a surgical treatment for sleep apnea syndrome.
OBJECTIVE
The aim of this study is to evaluate the results of primary hyoidthyroidpexia (HTP) and HTP after previous uvulopalatopharyngoplasty (UPPP) in patients with obstructive sleep apnea syndrome (OSAS).


METHODS
Prospective case series.


METHODS
Thirty-one patients with obstruction at tongue base level and moderate to severe sleep apnea syndrome underwent HTP. Seventeen patients underwent surgery after an unsuccessful UPPP (secondary HTP), and in 14 patients, primary HTP was performed.


RESULTS
Patients who underwent primary HTP showed a significant decrease in apnea hypopnea index (AHI) (P = .007), whereas those patients who had secondary HTP did not (P = .06). Overall, the AHI significantly changed (P = .0005). Visual analogue scales for snoring and hypersomnolence and the Epworth sleepiness scores showed significant improvement for both groups, without any difference between them. HTP was considerably less painful when compared with UPPP.


CONCLUSIONS
This study demonstrates that HTP, in particular as primary treatment in cases of obstruction at tongue base level, is a valuable addition to the therapeutic armamentarium of moderate to severe OSAS. Selection criteria are moderate to severe OSAS with preferably a body mass index less than 27, multilevel obstruction with emphasis on the base of tongue, small tonsils, and normal uvula, without a floppy epiglottis or a palatal stenosis after UPPP.
den Herder
Cindy
C
ENT Department, St. Lucas Andreas Hospital Amsterdam, Noord-Holland, The Netherlands.
van Tinteren
Harm
H
de Vries
Nico
N
D000402:Airway Obstruction / Q000145:classification / Q000601:surgery; D015992:Body Mass Index; D004825:Epiglottis / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006928:Hyoid Bone / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control; D010159:Palate / Q000473:pathology / Q000601:surgery; D014066:Palatine Tonsil / Q000473:pathology; D010614:Pharynx / Q000601:surgery; D017286:Polysomnography; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D012894:Sleep Stages / Q000502:physiology; D012913:Snoring / Q000601:surgery; D013957:Thyroid Cartilage / Q000601:surgery*; D014059:Tongue / Q000473:pathology; D014609:Uvula / Q000601:surgery