Evaluating outcomes of hyoid suspension combined with other upper airway surgery for obstructive sleep apnea.

OBJECTIVE: To assess the effectiveness of hyoid suspension in adults with OSA. METHODS: This is a retrospective case series of adult patients with OSA who underwent hyoid suspension at a single tertiary center. Patients were excluded if they did not have pre- and postoperative sleep study data. Change in AHI and ESS scores from preop to postop were estimated using paired t-tests. Data were analyzed using stratified analyses, simple linear regression models, and univariate logistic regression models. RESULTS: 43 patients underwent hyoid suspension from 2012 to 2023 with a mean (SD) age of 47.7 (9.5) years, mean (SD) BMI of 31.4 (6.9) kg/m2, and mean preoperative AHI of 30.6 (21.1) events/hr. Most patients had an adjuvant procedure performed concurrently, including palatal surgery (n = 11), genioglossus advancement (n = 3), or palatal surgery and genioglossus advancement (n = 24). There was a statistically significant improvement in the pre- and post-surgery AHI (mean decrease of -9.4 events/hr (95% CI − 17.1 to − 1.6, p = 0.019)) and ESS score (mean decrease of − 2.0 points (95% CI − 3.7 to − 0.3, p = 0.025)). Thirteen (30.2%) patients achieved success based on Sher20 criteria. CONCLUSIONS: Hyoid suspension with adjuvant OSA surgery results in statistically significant improvement in AHI and ESS scores, but additional research is needed to evaluate whether these results are clinically impactful. LEVEL OF EVIDENCE: 3.