Complications of hyoid suspension in the treatment of obstructive sleep apnea syndrome

Abstract

The objectives of the study are to assess adverse events and complications of hyoid suspension (HS) as a treatment of obstructive sleep apnea syndrome (OSAS). The study design was cohort. Thirty-nine patients with OSAS and obstruction at tongue base level, as assessed by sleep endoscopy, underwent HS. Information about adverse events and complications were obtained by reviewing charts and patient-completed questionnaires. The mean follow-up period from surgery to last control visit was 13.1 months (range 2-38). The charts demonstrated mainly adverse events. Minor complications occurred in six patients. No major complications were observed. The mean admission duration was 3.3 days (range 2-5). Twenty-six patients (67%) returned their questionnaires. No association was found between completing questionnaires and the success of the intervention (p = 0.73). The questionnaires were completed on average 25.9 months (range 3.5-51.5) after surgery. VAS scores showed a fast decline in complaints regarding taste, speech, swallowing and pain. No significant long-term differences were found, when comparing the postoperative VAS scores with the preoperative VAS scores. Of the 26 evaluable questionnaires, 20 patients (77%) would recommend HS to an acquaintance if they suffered from sleep apnea syndrome, when only taking side effects into consideration. The intention to give a positive recommendation did not seem to be related to the therapeutic success of the intervention. In conclusion, this study demonstrates that the complication rate of HS is low and that the discomfort is very acceptable.

Thirteen Years of Hyoid Suspension Experience in Multilevel OSAHS Surgery: The Short-Term Results of a Bicentric Study

“…Despite the increasing number of reports about hyoidthyroidpexia, there is still insufficient evidence to recommend one suspension technique over another [23]. Nevertheless, as far as we could experience and in accordance with the literature, hyoidthyroidpexia has been shown to be a safe procedure without any major complications [24]. …”

Heterotopic Ossification and Delayed Foreign Body Reaction after Hyoid Suspension for Obstructive Sleep Apnea

“…1,2 Surgical treatment of OSA includes the hyoid suspension procedure, which has relatively few complications. 3,4 Infection unresponsive to antibiotics can occur after thyrohyoid or hyomandibular suspension, 3 HO has not been reported after hyoid suspension; however, HO in the head and neck has been described in the trachea post-tracheostomy in a mechanically ventilated patient 5 and in the setting of stylohyoid ossification (Eagle's Syndrome). HO can occur in soft tissues without obligate proximity of bony structures, although in this case, typical for traumatic HO, proximity to bone supports the seeding theory regarding bone formation.…”

“…1,2 Surgical treatment of OSA includes the hyoid suspension procedure, which has relatively few complications. 3,4 Infection unresponsive to antibiotics can occur after thyrohyoid or hyomandibular suspension, 3 generally considered due to foreign body infection (personal communication with Dr Nico de Vries, May 2006), potentially explaining the partial erosion of the central hyoid bone underlying the suture material.…”

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

“…In addition, no infection had been observed. Richard et al [32] , reported a deviated tongue in one patient for a short period, which resolved within a few postoperative weeks, a wound abscess reported in another case and fistula in two patients, who needed more surgical interventions. Hou et al [33] , two patients had perioperative tongue swelling.…”