title: Outcomes of hyoid myotomy and suspension using a mandibular screw suspension system.
abstract: OBJECTIVE
  To review the outcomes of hyoid myotomy and suspension with a mandibular screw anchoring device.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  Academic and private sleep surgery clinics.
  
  
  METHODS
  The study is a consecutive case series of patients undergoing hyoid myotomy and suspension using a mandibular screw suspension device as part of multilevel treatment of obstructive sleep apnea (OSA). Outcomes of interest included complication rates, change in daytime sleepiness scores, and change in apnea-hypopnea index (AHI).
  
  
  RESULTS
  Ten women and 23 men with a mean age of 54 years (range, 33-73 years) underwent hyoid myotomy and suspension using a mandibular screw suspension device. Four (12%) patients experienced minor complications, including neck seroma (3 patients) and tongue edema (1 patient). Epworth Sleepiness Scale scores fell from a preoperative median of 12 to a postoperative median of 6 (P = .002). Ten patients (30%) refused the postoperative sleep study. In the 23 patients who underwent postoperative sleep studies, AHI scores decreased from a preoperative mean ± SD of 40.9 ± 25.1 to 18.6 ± 21.2 postoperatively (P = .001). Ten patients (30%) achieved a postoperative AHI below 10. The Repose system was initially applied using a standard hyoid dissection but was later modified using a minimally invasive small incision (<2 cm) approach that demonstrated significantly fewer complications (P = .04).
  
  
  CONCLUSIONS
  Hyoid myotomy and suspension with a mandibular screw anchor is an effective method with which to address hypopharyngeal collapse in multilevel surgery for OSA. The procedure can be performed with a small-incision, minimally invasive approach with minimal complications and patient morbidity.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA. gillesmb@musc.edu
authors.forename: M Boyd
authors.initials: MB
authors.lastname: Gillespie
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Ayers
authors.forename: Shaun A
authors.initials: SA
authors.lastname: Nguyen
authors.forename: Michael R
authors.initials: MR
authors.lastname: Abidin
mesh_terms: D000328:Adult; D000368:Aged; D001863:Bone Screws; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006928:Hyoid Bone / Q000601:surgery*; D008297:Male; D008334:Mandible; D008875:Middle Aged; D010027:Osteotomy / Q000295:instrumentation*; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D016896:Treatment Outcome