The Relationship Between Hyoid Suspension Change Of Surgical Hyoid Bone Position And Post-tongue Gap And Therapeutic Effect In OSAHS Patients

Objective To investigate the therapeutic effect of hyoid suspension in conjunction with uvulopalatopharyngoplasty,(UPPP) in the treatment of patients with severe obstructive sleep apnea hypopnea syndrome (OSAHS) with both velopharyngeal and glossopharyngeal plane obstruction, and the hyoid bone position and post-tongue gap changes were observed before and after hyoid suspension surgery, to analyze the correlation between changes and therapeutic effect.Methods Collected Clinical data of45patients hospitalized from February2008to February to2011in the Department of Otolaryngology Head and Neck Surgery Yantai Yuhuangding Hospital of Qingdao University, who were diagnosed with moderate or severe OSAHS after PSG test, and determined preoperatively with both velopharyngeal and glossopharyngeal plane obstruction, and25cases underwent UPPP surgery, while20patients underwent concomitant UPPP surgery and hyoid suspension. There was no statistical significance between the preoperative body mass index (BMI), sleep apnea-hypopnea index (AHI), lowest oxygen saturation (SO2),the Epworth Sleepiness Scale score (ESS) and snoring index of the2groups of patients. Two groups of patients ran PSG tests6months and1year after the surgery respectively, and their therapeutic effect were compared, and the preoperative and postoperative hyoid bone position and tongue space the changes of the group of patients who underwent hyoid suspension in conjunction with UPPP were measured at the same time.Results Patients were followed up postoperative for1year, and the effect of surgery were evaluated according to the OSAHS efficacy evaluation criteria by the Chinese Medical Association (April2002, Hangzhou). The total efficiency of the simple UPPP group and the group undergoing2surgeries were76%and85%respectively, and1year were52%and70%respectively, and there is no significant difference of the therapeutic effect between the2groups six months after surgery, but there is significant difference(p=0.031) in the long-term (after1year) effect of the two groups; the hyoid bone position of the patients who underwent2kinds of surgeries were moved forward and upward and their tongue clearance also increased significantly than before the surgeries.Conclusions Hyoid suspension surgery can help treat patients with OSAHS and glossopharyngeal plane obstruction by increasing the post hyoid space by tracting hyoid bone, and in case of patients with OSAHS with both velopharyngeal and glossopharyngeal plane obstruction, its long-term effect is better than mere UPPP surgery, the hyoid suspension combined with UPPP is an effective, simple and safe surgical method in the treatment of patients with both velopharyngeal and glossopharyngeal plane obstruction.