Hyoid SuspensionHyoid suspension is indicated primarily for the treatment of obstructive sleep apnea syndrome (OSAS) due to retrolingual (behind the tongue) airway obstruction. Because of the disproportionate anatomy in certain patients with OSAS, the airway collapses partially or completely in this location when a person sleeps. This results in a marked narrowing of the airway and prohibits normal respiration. Signs such as snoring or gasping to breathe may be witnessed. Symptoms vary depending on the severity of the OSAS. Daytime sleepiness and cognitive dysfunction are usually noted. In addition medical conditions such as high blood pressure, gastroesophageal reflux disease can be exacerbated. Severe, untreated OSAS is a major risk factor for heart attack and stroke. By preventing the tongue from collapsing against the back of the throat, one can partially or totally alleviate the obstructive signs and symptoms. Normally, the tongue is connected to a horseshoe shaped bone (hyoid bone) in the front of the neck just above the thyroid cartilage (Adam’s apple). By suturing the hyoid bone forward and suspending it from the thyroid cartilage, the base of tongue is less likely to collapse backwards against the back of the throat. Dr. Speyer will discuss the risks, benefits, and alternatives to this procedure with you in detail. Listed below are some of the disclosed risks of undergoing hyoid suspension. By reading and signing below, you are stating that you indeed understand the nature of the procedure, the risks as listed, and alternatives to undergoing the procedure. Risks of hyoid suspension include, but are not limited to, bleeding (immediate and delayed), infection, anterior neck incision scarring, failure to resolve all of the obstructive symptoms, the need for revision surgery, post-operative scarring and globus sensation (cotton ball in throat feel), and tightness in the throat upon swallowing. The latter, although may persist, is usually temporary. The natural contour of the neck in this area will also change with some fullness noted on profile just at the operative site. Injury to the nerves and blood vessels to the tongue is possible, but highly unlikely. Lastly, since the procedure is performed under a general anesthetic, this alone carries its own risks regardless of the surgery considered. You should discuss the specific risks with the anesthesiologist during your preoperative anesthetic appointment. To fully understand the effect that this procedure has on your sleep apnea, a post-operative sleep study is necessary. Typically this is arranged approximately 8-12 weeks after surgery.
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