Efficacy of Modified Hyoid Bone Suspension Technique Compared to Midline Glossectomy in Management of Hypopharyngeal Obstruction in Obstructive Sleep Apnea Patients

Abstract

Background: Obstructive sleep apnea (OSA) is a common and challenging health problem, especially in adults, as it is the second most common disease related to sleep. Surgical treatment plays an important role in management of OSA. However, the optimal procedure is not yet determined. Aim of the work: To compare between modified hyoid bone suspension and midline glossectomy in management of OSA due to hypopharyngeal obstruction. Patients and Methods:40 patients with OSA due to hypopharyngeal obstruction were randomly assigned to either modified hyoid bone suspension (group A; 20 patients) or midline glossectomy (group B; 20 patients). All had been assessed by full history, clinical examination and Lab investigations and underwent pre-assigned surgical intervention. Indicators of OSA such as minimal oxygen saturation, Apnea hypopnea Index [AHI] and Epworth Sleepiness Scale [ESS] had been measured preoperatively and 6 months after surgery. Results: The studied groups were comparable as patient characteristics and preoperative data. However, hyoid suspension was associated with significant decrease of AHI [16.67±6.06 vs 20.72±4.41] and ESS [9.10±2.42 vs 11.20±2.33]. Also, minimal oxygen saturation improved significantly in group A than group B. The percentage of responders increased significantly in group A (75.0% vs 40.0% respectively). Conclusion: Modified hyoid suspension is superior than the midline glossectomy, as a safer and more effective procedure for treatment of OSA due to hypopharyngeal obstruction.

Keywords

• obstructive sleep apnea
• apnea hypopnea index
• midline glossectomy
• hyoid suspension
• hypopharyngeal