Hyoidthyroidpexia as a treatment in multilevel surgery for obstructive sleep apnea.
CONCLUSIONS
This type of surgery is effective in patients with obstructive sleep apnea syndrome (OSAS), but may not be effective in obese patients or those with a preoperative apnea hypopnea index (AHI)>35. For these reasons, the careful study and selection of patients is fundamental in the surgical treatment of OSAS.


OBJECTIVE
Evaluation of the efficacy of hyoid surgery combined with oropharynx and nose surgery in the treatment of OSAS.


METHODS
A total of 109 OSAS patients underwent hyoidthyroidpexia as a treatment in multilevel surgery. Before surgery all patients were treated with continuous positive airway pressure (CPAP) therapy for at least 6 months and underwent preoperative and postoperative polysomnography. The preoperative examination was composed of upper airways endoscopy, lateral cephalometric radiograph, calculation of body mass index (BMI), and subjective analysis of daytime sleepiness.


RESULTS
In all, 67/109 patients (61.5%) with postoperative AHI<20 were defined as 'responders', while the other 42 patients (38.5%) were defined as 'non-responders'. The correlation between preoperative BMI and postoperative AHI revealed that non-responders had a much higher average BMI compared with responders. Moreover, when analyzing median preoperative and postoperative AHI, it emerged that non-responders had a much higher preoperative AHI compared with responders.
Benazzo
Marco
M
Department of Otorhinolaryngology, Foundation IRCCS Policlinico San Matteo, University of Pavia. m.benazzo@smatteo.pv.it
Pagella
Fabio
F
Matti
Elina
E
Zorzi
Stefano
S
Campanini
Aldo
A
Frassineti
Sabrina
S
Montevecchi
Filippo
F
Tinelli
Carmine
C
Vicini
Claudio
C
D005260:Female; D006801:Humans; D006928:Hyoid Bone / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009300:Nasal Septum / Q000601:surgery; D010160:Palate, Soft / Q000601:surgery; D010614:Pharynx / Q000601:surgery; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000601:surgery*; D013957:Thyroid Cartilage / Q000601:surgery*; D014420:Turbinates / Q000601:surgery; D014609:Uvula / Q000601:surgery