title: Hyoid surgery alone for obstructive sleep apnea: A systematic review and meta-analysis.
abstract: The primary objective was to determine if sleep study variables (e.g., apnea-hypopnea index [AHI] and lowest oxygen saturation) and quantitative sleepiness data improve following isolated hyoid surgery for obstructive sleep apnea (OSA).
  
  
  
  Systematic review and meta-analysis.
  
  
  
  Nine databases, including PubMed, were searched through September 5, 2015.
  
  
  
  Four hundred ninety-eight studies were screened, 64 were reviewed, and nine studies met inclusion criteria. A total of 101 patients were identified who underwent hyoid surgery alone for treatment of OSA. Subanalyses were performed for: 1) type of surgery, 2) primary versus secondary hyoid surgery, 3) positional versus nonpositional OSA, 4) age, and 5) body mass index. In patients undergoing isolated hyoid surgery, the AHI decreased from a mean ± standard deviation of 37.3 ± 21.1 (95% confidence interval [CI]: 33.1, 41.5) to 23.0 ± 18.6 (95% CI: 19.3, 26.7) events/hour, which correspond to a 38.3% reduction (P < .0001). AHI reduced by 38.3% for hyoid myotomy with suspension, by 50.7% for hyothyroidopexy, and by 7.1% for hyoid expansion. The Epworth Sleepiness Scale decreased by 3.2 points from 10.3 ± 4.9 (95% CI: 8.8, 11.8) to 7.1 ± 4.2 (95% CI: 5.8, 8.4; P = .0027).
  
  
  
  Isolated hyoid surgery has reduced OSA severity and improved sleepiness in adults. Hyothyroidopexy provided a 50.7% reduction in AHI, followed by hyoid myotomy with suspension (38.3% reduction in AHI) and hyoid expansion (7.1% reduction in AHI). The current literature lacks high-quality evidence with regard to hyoid surgery, and additional studies are needed to further elucidate the effect of hyoid surgery in OSA.
  
  
  
  NA Laryngoscope, 126:1702-1708, 2016.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Division of Sleep Surgery and Medicine, Tripler Army Medical Center, Honolulu, Hawaii, U.S.A.
authors.forename: Sungjin A
authors.initials: SA
authors.lastname: Song
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Division of Sleep Surgery and Medicine, Tripler Army Medical Center, Honolulu, Hawaii, U.S.A.
authors.forename: Justin M
authors.initials: JM
authors.lastname: Wei
authors.affiliation: College of Medicine, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Buttram
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Division of Sleep Surgery and Medicine, Tripler Army Medical Center, Honolulu, Hawaii, U.S.A.
authors.forename: Anthony M
authors.initials: AM
authors.lastname: Tolisano
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Division of Sleep Surgery and Medicine, Tripler Army Medical Center, Honolulu, Hawaii, U.S.A.
authors.forename: Edward T
authors.initials: ET
authors.lastname: Chang
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Division of Sleep Surgery and Medicine, Stanford Hospitals and Clinics, Stanford, California, U.S.A.
authors.forename: Stanley Yung-Chuan
authors.initials: SY
authors.lastname: Liu
authors.affiliation: Department of Otorhinolaryngology/Sleep Medicine Centre, Hospital CUF, Porto, Portugal.|Centre for Research in Health Technologies and Information Systems, University of Porto, Porto, Portugal.
authors.forename: Victor
authors.initials: V
authors.lastname: Certal
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Division of Sleep Surgery and Medicine, Tripler Army Medical Center, Honolulu, Hawaii, U.S.A.|Department of Psychiatry and Behavioral Sciences, Sleep Medicine Division, Stanford Hospital and Clinics, Stanford, California, U.S.A.
authors.forename: Macario
authors.initials: M
authors.lastname: Camacho
mesh_terms: D006801:Humans; D006928:Hyoid Bone / Q000601:surgery*; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D016896:Treatment Outcome
keywords: Obstructive sleep apnea; hyoid surgery; meta-analysis; systematic review