Hyoid suspension versus laser midline glossectomy in the management of obstructive sleep apnea

Abstract

Background The base of the tongue and the hypopharynx are the major sites of obstruction in up to 50% of patients with obstructive sleep apnea (OSA) possibly explaining the cause of failure in palatal surgery. Hyoid suspension and laser midline glossectomy can be used as a surgical treatment for tongue base and hypopharyngeal collapse. Objective The aim of this study was to compare hyoid suspension type I and laser midline glossectomy in the management of OSA as regards safety, efficiency, and postoperative morbidity and mortality. Patients and methods In this study, 30 patients were diagnosed as having OSA by means of polysomnography with retrolingual collapse using Muller maneuver. Fifteen patients were operated upon using hyoid suspension type I and the other 15 patients were operated upon using laser midline glossectomy. Results In hyoid suspension type I, the incidence of responder patients [50% or more reduction in their apnea–hypopnea index (AHI) plus reduction in the AHI below 20] was 66.67%, with reduction in the AHI by 77.2%, and the incidence of nonresponder patients was 33.33%, with reduction in the AHI by 36.17%. However, in midline laser glossectomy, the incidence of responder patients was 53.34% with reduction in the AHI by 73.87%, and the incidence of nonresponder patients was 46.67% with reduction in the AHI by 40.79%. Complications were higher in laser midline glossectomy compared with hyoid suspension type I. Conclusion Our data indicate that hyoid suspension type I may be safer and more effective with lesser morbidity compared with laser midline glossectomy.