[Effects of hyoid position on surgical treatment outcome for patients with obstructive sleep apnea hypopnea syndrome].

OBJECTIVE:To evaluate the predictive value of the position of the hyoid in surgical outcomes of velopharyngeal surgery for obstructive sleep apnea hypopnea syndrome (OSAHS). METHODS:The polysomnography, CT, and anthropometry data were retrospectively reviewed from patients who underwent revised uvulopalatopharyngoplasty with uvula preservation (H-UPPP) simply or the combination of H-UPPP and transpalatal advance pharyngoplasty (TAP) for OSAHS from July 2008 to December 2011. OSAHS was diagnosed by polysomnography (PSG) in 128 patients who underwent H-UPPP or H-UPPP with TAP surgery for their sleep disorder. After surgical treatment, the patients were evaluated by PSG. RESULTS:The 128 patients included were all male, the mean age of these patients was (39.6±8.5) years, ranged from 19 to 66 years. Seventy-seven patients were successfully treated and 51 did not respond to surgical treatment. The overall apnea hypopnea index (AHI) improved from (58.2±22.4) times/h preoperatively to (20.6±18.1) times/h postoperatively (t=14.9, P<0.001). The vertical distance from inferior margin of hyoid to the inferior mandibular margin (D-HM) was the only parameter that had a significant difference between responders [(14.6±7.7)mm] and non-responders [(19.4±8.0)mm] (t=3.452, P=0.001). D-HM, AHI and the lowest blood oxygen saturation were significant predictors of surgical outcomes (P<0.05). There was a significant correlation between the D-HM and the postoperative AHI (r=0.284, P=0.001). The D-HM of ≥23 mm could predict the postoperative AHI of >10 times/h a specificity of 95.2%. CONCLUSION:The D-HM is a negative predictor of surgical outcomes, patients with a D-HM of ≥23 mm are inappropriate candidates for velopharyngeal surgery.