title: [Complications of hyoid suspension with Repose system on obstructive sleep apnea hypopnea syndrome].
abstract: OBJECTIVE
  To investigate the complications of hyoid suspension with Repose system on obstructive sleep apnea hypopnea syndrome (OSAHS) and to find out the effective prevention strategies.
  
  
  METHODS
  Forty four patients diagnosed by polysomnography as OSAHS were received hyoid suspension with Repose system from June 2005 to July 2009. The intraoperative and postoperative complications were analyzed retrospectively. The patients who reported abnormal swallowing were evaluated with water drinking test and video fluorography swallow study to assess biomechanical changes in swallowing.
  
  
  RESULTS
  Incidence rate of perioperative titanium nial amotio was 15.9% (7/44). It was avoided by implanting titanium nial again. No perioperative complications occurred such as injury of superior laryngeal nerve, blood vessel and thyrohyoid membrane, fracture of hyoid bone, suture break. All patients developed dysfunctions of pronunciation and swallowing, edema of mouth floor, dysfunctions of movement of tongue that could relieved gradually after three days on most patients. No postoperative complications occurred such as titanium nial amotio, fat liquoring, edema of mouth floor, hematoma, infection, foreign body reaction, injury of root apex of anterior tooth, dysfunctions of movement and sensation of tongue, suture break and death. All patients had over 2 year postoperative follow up. Incidence rate of dysfunctions of pronunciation and swallowing was 4.5% (2/44) and 15.9% (7/44) respectively. Main situation for dysfunctions of pronunciation was speaking ambiguity. Major manifestations of swallowing abnormalities were occasional aspiration, food going down the wrong tube, food becoming stuck in the throat, deglutition with bowing head. Seven patients who had abnormal swallowing possessed normal water drinking test and occurred asynersis of hyoid movement and laryngeal elevation, but aspiration were not observed. Three patients presented obvious stagnation in epiglottic vallecula and sinus piriformis.
  
  
  CONCLUSIONS
  Most complications of hyoid suspension with Repose system may be avoided or recovered on short term. Postoperative dysfunctions of pronunciation and swallowing may exist for a long time.
authors.affiliation: Sleep Disordered Breathing Center, Department of Otorhinolaryngology, Head and Neck Surgery, Renmin Hospital of Wuhan University, China.
authors.forename: Jin-hui
authors.initials: JH
authors.lastname: Chen
authors.forename: Zhi-hong
authors.initials: ZH
authors.lastname: Luo
authors.forename: Rui
authors.initials: R
authors.lastname: Yang
authors.forename: Jing
authors.initials: J
authors.lastname: Kang
authors.forename: Yong-ping
authors.initials: YP
authors.lastname: Wang
authors.forename: Xi-lin
authors.initials: XL
authors.lastname: Yang
authors.forename: Ming-wan
authors.initials: MW
authors.lastname: Zhu
authors.forename: Ze-zhang
authors.initials: ZZ
authors.lastname: Tao
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D006928:Hyoid Bone / Q000601:surgery*; D007431:Intraoperative Complications / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000601:surgery*