title: Hyoid myotomy without suspension: a surgical approach to obstructive sleep apnoea syndrome.
abstract: The aim of this study was to verify if hyoid myotomy without hyoid suspension is effective in surgical treatment of obstructive sleep apnoea syndrome (OSAS). We recruited six patients with OSAS, aged between 34 to 60 years, with retropalatal and retrolingual upper airway obstruction, non-obese (BMI < 27) and non-compliant to continuous positive airway pressure therapy. Pre-surgical clinical and instrumental evaluations included clinical examination, cephalometry, polysomnography (PSG) and sleep endoscopy. Surgical treatment included nasal surgery, uvulopalatopharyngoplasty, tonsillectomy and hyoid myotomy without hyoid suspension. Follow-up evaluations were performed with serial PSGs, performed early (one week after surgery), and at 1, 6 and 18 months after surgery. We observed that surgery was followed by immediate normalisation of breathing parameters evaluated by PSG that persisted after 18 months. Thus, hyoid myotomy without suspension combined with nasal and palatal surgery may be considered a valid treatment of non-obese OSAS patients with retrolingual and retropalatal collapse. Furthermore, we suggest that hyoid bone suspension, binding it to mandibular or to thyroid cartilage, might be unnecessary in selected cases.
authors.affiliation: Institute of Otorhinolaryngology, Catholic University Rome, Italy;
authors.forename: E
authors.initials: E
authors.lastname: Scarano
authors.affiliation: Department of Neurosciences, Catholic University Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Della Marca
authors.affiliation: Institute of Otorhinolaryngology, Catholic University Rome, Italy;
authors.forename: E
authors.initials: E
authors.lastname: De Corso
authors.affiliation: Institute of Otorhinolaryngology, Catholic University Rome, Italy;
authors.forename: S
authors.initials: S
authors.lastname: Dittoni
authors.affiliation: Institute of Otorhinolaryngology, Catholic University Rome, Italy;
authors.forename: W
authors.initials: W
authors.lastname: Di Nardo
authors.affiliation: Institute of Otorhinolaryngology, Catholic University Rome, Italy;
authors.forename: D
authors.initials: D
authors.lastname: Meucci
authors.affiliation: Institute of Otorhinolaryngology, Catholic University Rome, Italy;
authors.forename: G
authors.initials: G
authors.lastname: Bastanza
authors.affiliation: Institute of Otorhinolaryngology, Catholic University Rome, Italy;
authors.forename: R
authors.initials: R
authors.lastname: Gallus
authors.affiliation: Department of Neurosciences, Catholic University Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Losurdo
authors.affiliation: Department of Neurosciences, Catholic University Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Testani
authors.affiliation: Institute of Otorhinolaryngology, Catholic University Rome, Italy;
authors.forename: G
authors.initials: G
authors.lastname: Paludetti
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D006928:Hyoid Bone; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000601:surgery*
keywords: Hyoid myotomy; Obstructive sleep apnoea syndrome; Sub-hyoid muscles; Uvulopalatopharyngoplasty