Hyoid Expansion With Titanium Plate and Screw

Toh, Song-Tar; Hsu, Pon Poh; Tan, Kah Leong Alvin; Lu, Kuo-Sun Peter; Han, Hong-Juan

doi:10.1001/jamaoto.2013.3906

Cited by 6 publications

(1 citation statement)

References 13 publications

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“…Increased airflow and reduced closing pressure of the upper airway were achieved with expansion hyoidplasty in the canine model. Human cadaveric study also showed the increase of retrolingual hypopharyngeal airway space with hyoid expansion [16]. The greater horn is a significant structure.…”

Section: Discussionmentioning

confidence: 83%

The Dimension of Hyoid Bone Is Independently Associated with the Severity of Obstructive Sleep Apnea

Min

Ahn

et al. 2013

PLoS ONE

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IntroductionWe hypothesized that the size of the hyoid bone itself may affect the severity of sleep apnea. The aim of this study was to identify the relationship between hyoid bone dimensions and the severity of sleep apnea using computerized tomography (CT) axial images.MethodsWe retrospectively measured the hyoid bone in axial images of neck CTs and correlated these measurements with results of polysomnography in a total of 106 male patients. The new hyoid bone parameters studied in this study were as follows: distance between bilateral lesser horns (LH-d), distance between bilateral greater horns (GH-d), distance from the most anterior end of the hyoid arch to GH-d (AP), distance from the greater to the lesser horn on right and left sides (GH-LH), and the anterior angle between bilateral extensive lines from the greater to the lesser horn (H-angle). Data was analyzed using univariate and multivariate logistic regression, and Pearson correlation tests.ResultsWe found a significant inverse correlation between the apnea-hypopnea index (AHI) and GH-d or AP. Neither the LH-d, GH-LH, nor H-angle were associated with the AHI. The patient group that met the criteria of both GH-d<45.4 and AP<33.4 demonstrated the most severe AHI.ConclusionThe lateral width or antero-posterior length of hyoid bone was associated with AHI and predicted the severity of sleep apnea in male patients. This finding supports the role of expansion hyoidplasty for treatment of sleep apnea. Pre-operative consideration of these parameters may improve surgical outcomes in male patients with sleep apnea.

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Section: Discussionmentioning

confidence: 83%

The Dimension of Hyoid Bone Is Independently Associated with the Severity of Obstructive Sleep Apnea

Min

Ahn

et al. 2013

PLoS ONE

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Hyoid expansion with titanium plate and screws with hyomandibular suspension: A study on human cadavers with computed tomographic comparative analysis

Salkade

Rangabashyam

et al. 2020

Laryngoscope Investig Oto

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Objective(s): Obstructive sleep apnoea is characterized by repetitive obstruction of the upper airway during sleep. These repeated oxygen desaturations increase cardiovascular and cerebrovascular morbidity and mortality significantly. Upper airway surgery is an option for patients who fail continuous positive airway pressure therapy. Airway collapse is usually multilevel and hypopharyngeal collapse is a challenging area to address. It is hypothesized that hyoid expansion with hyomandibular suspension can potentially increase upper airway dimensions at the hypopharynx. This study aims to document the effect of hyoid expansion using titanium plate and screws with hyomandibular suspension on hypopharyngeal airway dimensions. It is an anatomical feasibility study performed using 10 human cadaver heads. Methods: The hyoid bone is trifractured. The expanded hyoid is then suspended to the mandible. Computed tomography (CT) scans were performed on the cadavers to measure the airway dimensions before and after the procedure. Results: This procedure resulted in statistically significant increase in airway dimensions at the level of the hypopharynx in all 10 human cadaver heads. Increase in cross-sectional area correlated significantly with increase in 3-dimentional (3D) volume. The mean area of the airway at the level of the hyoid increased from 999.3 ± 193.0 mm 2 to 1241.4 ± 103.2 mm 2. Statistically significant increase in upper airway volume based on 3D reconstruction was also noted. Upper airway volume increased from 6.94 ± 6.46 mL to 13.58 ± 8.29 mL.

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Changing practice: Trends in skeletal surgery for obstructive sleep apnea

Awad

Gouveia

Zaghi³

et al. 2019

Journal of Cranio-Maxillofacial Surgery

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Hyoid Expansion With Titanium Plate and Screw

Abstract: The retrolingual hypopharyngeal airway space increased with hyoid expansion using titanium plate and screw in our human cadaveric study, measured using CAM. The degree of increase is further augmented with hyomandibular suspension.

Cited by 6 publications

References 13 publications

The Dimension of Hyoid Bone Is Independently Associated with the Severity of Obstructive Sleep Apnea

The Dimension of Hyoid Bone Is Independently Associated with the Severity of Obstructive Sleep Apnea

Hyoid expansion with titanium plate and screws with hyomandibular suspension: A study on human cadavers with computed tomographic comparative analysis

Changing practice: Trends in skeletal surgery for obstructive sleep apnea

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