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Hyoid surgery alone for obstructive sleep apnea: A systematic review and meta-analysis

Authors :
Anthony M. Tolisano
Victor Certal
Edward T. Chang
Macario Camacho
Jonathan Buttram
Sungjin A. Song
Justin M. Wei
Stanley Yung-Chuan Liu
Source :
The Laryngoscope. 126:1702-1708
Publication Year :
2016
Publisher :
Wiley, 2016.

Abstract

Objectives/Hypothesis The primary objective was to determine if sleep study variables (e.g., apnea-hypopnea index [AHI] and lowest oxygen saturation) and quantitative sleepiness data improve following isolated hyoid surgery for obstructive sleep apnea (OSA). Study Design Systematic review and meta-analysis. Methods Nine databases, including PubMed, were searched through September 5, 2015. Results Four hundred ninety-eight studies were screened, 64 were reviewed, and nine studies met inclusion criteria. A total of 101 patients were identified who underwent hyoid surgery alone for treatment of OSA. Subanalyses were performed for: 1) type of surgery, 2) primary versus secondary hyoid surgery, 3) positional versus nonpositional OSA, 4) age, and 5) body mass index. In patients undergoing isolated hyoid surgery, the AHI decreased from a mean ± standard deviation of 37.3 ± 21.1 (95% confidence interval [CI]: 33.1, 41.5) to 23.0 ± 18.6 (95% CI: 19.3, 26.7) events/hour, which correspond to a 38.3% reduction (P < .0001). AHI reduced by 38.3% for hyoid myotomy with suspension, by 50.7% for hyothyroidopexy, and by 7.1% for hyoid expansion. The Epworth Sleepiness Scale decreased by 3.2 points from 10.3 ± 4.9 (95% CI: 8.8, 11.8) to 7.1 ± 4.2 (95% CI: 5.8, 8.4; P = .0027). Conclusions Isolated hyoid surgery has reduced OSA severity and improved sleepiness in adults. Hyothyroidopexy provided a 50.7% reduction in AHI, followed by hyoid myotomy with suspension (38.3% reduction in AHI) and hyoid expansion (7.1% reduction in AHI). The current literature lacks high-quality evidence with regard to hyoid surgery, and additional studies are needed to further elucidate the effect of hyoid surgery in OSA. Level of Evidence NA Laryngoscope, 2015

Details

ISSN :
0023852X
Volume :
126
Database :
OpenAIRE
Journal :
The Laryngoscope
Accession number :
edsair.doi...........1dea84d5a90c8f648b74f384271f23d5
Full Text :
https://doi.org/10.1002/lary.25847