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Hyoid suspension, also known as hyoid myotomy and suspension or hyoid advancement, is a surgical procedure or sleep surgery in which the hyoid bone and its muscle attachments to the tongue and airway are pulled forward with the aim of increasing airway size and improving airway stability in the retrolingual and hypopharyngeal airway (airway behind and below the base of tongue).
A little over 50% of all people with Down syndrome experience obstructive sleep apnea, [57] and some physicians advocate routine testing of this group. [58] In other craniofacial syndromes, the abnormal feature may actually improve the airway, but its correction may put the person at risk for obstructive sleep apnea after surgery when it is ...
Obstructive sleep apnea or sleep apnea is defined as either cessation of breathing (apnea) for 10 seconds, or a decrease in normal breathing (hypopnea) with an associated desaturation in oxygen and arousal during sleep that lasts at least 10 seconds. In adults, it is typical to have up to 4.9 events per hour.
Sleep apnea (sleep apnoea or sleep apnœa in British English) is a sleep-related breathing disorder in which repetitive pauses in breathing, periods of shallow breathing, or collapse of the upper airway during sleep results in poor ventilation and sleep disruption.
The implant may be configured to best accommodate the patient's comfort and sleeping habits (e.g., set a delay based on sleep latency). The hypoglossal nerve stimulator implantable pulse generator battery life typically lasts 8–12 years, after which the implantable pulse generator may be safely replaced with another surgery. [8]
The Stanford Protocol is a combination of surgeries that are undertaken to treat obstructive sleep apnea. The Protocol involves two phases, the first of which involves UPPP and one or more of Genioglossus Advancement or Hyoid Suspension. The Second Phase of the operation involves maxillomandibular advancement.
The first involves surgery of the soft tissue (tonsillectomy, uvulopalatopharyngoplasty) and the second involves skeletal surgeries (maxillomandibular advancement). First, Phase 1 or soft tissue surgery is performed and after re-testing with a new sleep study, if there is residual sleep apnea, then Phase 2 surgery would consist of jaw surgery.
Sleep apnea is measured by the apnea-hypopnea index (AHI). An AHI is determined with a sleep study. AHI values for adults are categorized as: [2] [3] Normal: AHI<5; Mild sleep apnea: 5≤AHI<15; Moderate sleep apnea: 15≤AHI<30; Severe sleep apnea: AHI≥30; An episode is when a person hesitates to breathe or stops their breathing altogether.