Hyoid expansion with titanium plate and screw: a human cadaveric study using computer-assisted airway measurement.
OBJECTIVE
Hyoid expansion with suspension can potentially increase the upper airway at the hypopharyngeal level, benefitting patients with sleep-related breathing disorder.


OBJECTIVE
To document the effect of hyoid expansion using titanium plate and screw on retrolingual hypopharyngeal airway dimension and to compare the airway dimension after isolated hyoid expansion with hyoid expansion + hyomandibular suspension.


METHODS
Anatomical cadaveric dissection study.


METHODS
This study was performed in a laboratory setting using human cadavers.


METHODS
This is an anatomical feasibility study of hyoid expansion using titanium plate and screw on 10 cadaveric human heads and necks. The hyoid bone is trifractured with bony cuts made just medial to the lesser cornu. The freed hyoid body and lateral segments are expanded and stabilized to a titanium adaptation plate. Computer-assisted airway measurement (CAM) was used to measure the airway dimension at the hypopharynx at the level of the tongue base before and after the hyoid expansion. The expanded hyoid bone was then suspended to the mandible, and the airway dimension was measured again with CAM.


METHODS
Airway dimension after isolated hyoid expansion with hyoid expansion with hyomandibular suspension. RESULTS Hyoid expansion with titanium plate and screw resulted in statistical significant increase in the retrolingual hypopharyngeal airway space in all of the 10 human cadavers. The mean (SD) increase in retroglossal area was 33.4 (13.2) mm² (P < .005) (range, 6.0-58.7 mm²). Hyoid expansion with hyomandibular suspension resulted in a greater degree of airway enlargement. The mean (SD) increase in retroglossal area was 99.4 (15.0) mm² (P < .005) (range, 81.9-127.5 mm²).


CONCLUSIONS
The retrolingual hypopharyngeal airway space increased with hyoid expansion using titanium plate and screw in our human cadaveric study, measured using CAM. The degree of increase is further augmented with hyomandibular suspension.
Sleep Apnea Surgery Service, Department of Otolaryngology-Head and Neck Surgery, Singapore General Hospital, Singapore. songtar@gmail.com
Song-Tar
ST
Toh
Pon-Poh
PP
Hsu
Kah Leong Alvin
KL
Tan
Kuo-Sun Peter
KS
Lu
Hong-Juan
HJ
Han
D001860:Bone Plates; D001863:Bone Screws; D002102:Cadaver; D003936:Diagnosis, Computer-Assisted; D005240:Feasibility Studies; D006801:Humans; D006928:Hyoid Bone / Q000033:anatomy & histology / Q000601:surgery*; D007013:Hypopharynx / Q000502:physiology*; D012680:Sensitivity and Specificity; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D014025:Titanium
D014025:Titanium