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© Georg Thieme Verlag KG Stuttgart · New York
Probleme der hyomandibulären Pexie bei Patienten mit OSASProblems of Hyomandibulopexia in Patients with OSAS
09 October 2006 (online)
Problems of Hyomandibulopexia in Patients with OSAS
In cases of obstructive sleep apnea syndrome (OSAS) with intolerance of n-CPAP (nasal continuous positive airway pressure) treatment, hyoidthyroidpexia (synonym: hyoid suspension) has recently been advocated by some authors as a valuable surgical option. Despite a basically positive assessment, there is a risk of hindrance the speaking and swallowing function. Moreover, the thyroid cartilage seems to be too weak for fixation of the hyoid with its complex muscular attachments. This reduces the likelihood of achieving positive long-term results.
Considering aspects of preserving laryngeal function, we are reporting on 7 patients submitted to a hyomandibulopexia. This intervention counteracts the tendency of the tongue base to collapse by ventrolateral traction on the hypoglossal muscle via the severed greater horn of the hyoid. We have thus far had to correct our surgical procedure three times because of methodological problems in the postoperative phase. Specific problems with surgical materials like steel wire or Goretex® are discussed. In conclusion, we explain why we consider a bone anchored Kevlar suture (FASTak of Arthrex®) to be suitable for this operation.
Considering functional aspects, our polysomnographic and phoniatric follow-up examinations point to a less traumatic surgical procedure with promising treatment results.
Key words: Hyoid Suspension Hyoidthyroidpexia Hyomandibulopexia Hyoid Bone Bone Wires.
- 01 den Herder C . van Tinteren H . de Vries N . Hyoidthyroidpexia: A surgical treatment for sleep apnea syndrome. Laryngoscope. 2005; 115 740-745
- 02 Hörmann K . Baisch A . The hyoid suspension. Laryngoscope. 2004; 114 1677-1679
- 03 Riley RW . Powell NB . Guilleminault C . Obstructive sleep apnea and the hyoid: A revised surgical procedure. Otolaryngol Head Neck Surg. 1994; 111 717-721
- 04 Verse T . Baisch A . Maurer JT . Stuck BA . Hörmann K . Multilevel surgery for obstructive sleep apnea: Short-term results. Otolaryngol Head Neck Surg. 2006; 134 571-577
- 05 Hörmann K . Hirth K . Erhardt T . Maurer JT . Verse T . Modified hyoid suspension for therapy of sleep related breathing disorders. Operative technique and complications. Laryngorhinootologie. 2001; 80 517-521
- 06 Kaya N . Sectioning the hyoid bone as a therapeutic approach for obstructive sleep apnea. Sleep. 1984; 7 77-78
- 07 Riley R . Guilleminault C . Powell N . Derman S . Mandibular osteotomy and hyoid bone advancement for obstructive sleep apnea: A case report. Sleep. 19984; 7 79-82
- 08 Coleman J . Bick PA . Suspension sutures for the treatment of obstructive sleep apnea and snoring. Otolaryngol Clin North Am. 1999; 32 277-285
- 09 Sobotta: Atlas der Anatomie des Menschen B, 22. München: Elsevier, Urban & Fischer; 2005.