Publication:
Hyoid myotomy with suspension under local anesthesia for obstructive sleep apnea syndrome

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Issued Date

2003

Resource Type

Article

File Type

application/pdf

ISSN

9374477

DOI

10.1007/s00405-002-0560-0

Other identifier(s)

2-s2.0-0038459199

Rights Holder(s)

มหาวิทยาลัยศรีนครินทรวิโรฒ

Bibliographic Citation

European Archives of Oto-Rhino-Laryngology. Vol 260, No.5 (2003), p.286-290

Suggested Citation

Neruntarat C. Hyoid myotomy with suspension under local anesthesia for obstructive sleep apnea syndrome. European Archives of Oto-Rhino-Laryngology. Vol 260, No.5 (2003), p.286-290. doi:10.1007/s00405-002-0560-0 Retrieved from: https://hdl.handle.net/20.500.14740/6626

Title

Hyoid myotomy with suspension under local anesthesia for obstructive sleep apnea syndrome

Author(s)

Neruntarat C.

Abstract

Upper airway obstruction of patients with obstructive sleep apnea syndrome (OSAS) occurring during sleep can appear at multiple sites. Successful results of hyoid myotomy with suspension (HM) in the treatment of hypopharyngeal obstruction performed under general anesthesia have been reported. However, many OSAS patients have difficulty at the induction of anesthesia and intubation. They are predisposed to specific complications owing to anatomical abnormalities of the airway and the existence of an underlying syndrome. The purpose of this study was to assess the safety and efficacy of HM for the treatment of OSAS under local anesthesia. Thirty-two OSAS patients with hypopharyngeal obstruction underwent HM under local anesthesia. The hyoid bone was suspended to the superior aspect of the thyroid cartilage. Uvulopalatal flap was an adjunct surgical procedure for palatal obstruction. Patients had a mean age of 39.2±5.7 years and a body mass index of 29.3±2.4 kg/m2. Data on the patients were compared from preoperative to postoperative assessment points. Statistical analysis was performed using the Student's t-test. All patients tolerated the procedure well. The mean follow-up was 8.1±2.4 months (range 5 to 10 months). The mean RDI decreased from 44.5±8.7 to 15.2±5.6 (P <0.001), and the lowest oxygen saturation increased from 82.1±3.7% to 87.9±2.7% (P <0.01). The Epworth sleepiness scale improved from 14.1±2.2 to 8.2±2.3 (P <0.01), and the snoring scale improved from 8.5±1.8 to 3.5±1.7 (P <0.001). Postoperative complications included transient dysphagia in 3% of the patients and transient aspiration in 9%. Bleeding, infection and airway obstruction were not observed. Most patients had mild to moderate pain (visual analog scale ≤7) for 5 to 7 days after the procedures. Responders were defined as OSAS patients who had a reduction in the respiratory disturbance index (RDI) of 50% or more and a RDI of 20 or less after surgery. By these criteria, 78% of the patients were regarded as having responded to HM. A significant reduction in the RDI and clinical improvements were observed after HM. It appears to be a safe, inexpensive and effective procedure that can be performed under local anesthesia with a low probability of complications.

Subject(s)

Adrenalin
 Bupivacaine
 Lidocaine
 Local anesthetic agent
 Adult
 Airway obstruction
 Anesthesia induction
 Article
 Bleeding
 Clinical article
 Cost effectiveness analysis
 Disease predisposition
 Dysphagia
 Female
 Human
 Hyoid bone
 Hypopharynx
 Infection
 Intubation
 Local anesthesia
 Male
 Myotomy
 Pain assessment
 Postoperative complication
 Priority journal
 Respiratory disturbance index
 Respiratory function
 Risk benefit analysis
 Safety
 Sleep apnea syndrome
 Sleep disorder
 Statistical analysis
 Statistical significance
 Student t test
 Surgical risk
 Syndrome delineation
 Thyroid gland

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URI

https://hdl.handle.net/20.500.14740/6626

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Scopus: Year 1983-2021

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