Hyoidthyroidpexia: A Surgical Treatment for Sleep Apnea Syndrome
Article first published online: 3 JAN 2009
Copyright © 2005 The Triological Society
Volume 115, Issue 4, pages 740–745, April 2005
How to Cite
den Herder, C., van Tinteren, H. and de Vries, N. (2005), Hyoidthyroidpexia: A Surgical Treatment for Sleep Apnea Syndrome. The Laryngoscope, 115: 740–745. doi: 10.1097/01.mlg.0000156464.37681.BF
- Issue published online: 3 JAN 2009
- Article first published online: 3 JAN 2009
- Manuscript Accepted: 7 JAN 2005
- obstructive sleep apnea syndrome;
- tongue base obstruction;
- UPPP failure
Objectives/Hypothesis: The aim of this study is to evaluate the results of primary hyoidthyroidpexia (HTP) and HTP after previous uvulopalatopharyngoplasty (UPPP) in patients with obstructive sleep apnea syndrome (OSAS).
Study Design: Prospective case series.
Methods: Thirty-one patients with obstruction at tongue base level and moderate to severe sleep apnea syndrome underwent HTP. Seventeen patients underwent surgery after an unsuccessful UPPP (secondary HTP), and in 14 patients, primary HTP was performed.
Results: Patients who underwent primary HTP showed a significant decrease in apnea hypopnea index (AHI) (P = .007), whereas those patients who had secondary HTP did not (P = .06). Overall, the AHI significantly changed (P = .0005). Visual analogue scales for snoring and hypersomnolence and the Epworth sleepiness scores showed significant improvement for both groups, without any difference between them. HTP was considerably less painful when compared with UPPP.
Conclusion: This study demonstrates that HTP, in particular as primary treatment in cases of obstruction at tongue base level, is a valuable addition to the therapeutic armamentarium of moderate to severe OSAS. Selection criteria are moderate to severe OSAS with preferably a body mass index less than 27, multilevel obstruction with emphasis on the base of tongue, small tonsils, and normal uvula, without a floppy epiglottis or a palatal stenosis after UPPP.