Genioglossus advancement and hyoid suspension plus uvulopalatopharyngoplasty for severe OSAHS.

OBJECTIVE

To evaluate the outcome of a comprehensive surgical approach on the treatment of severe obstructive sleep apnea hypopnea syndrome (OSAHS) and find out possible predictors to the effectiveness of this approach.

STUDY DESIGN AND SETTING

Eighteen patients received genioglossus advancement with hyoid suspension (GAHM) and uvulopalatopharyngoplasty (UPPP). The multiple logistic regression was used to analyze predictors for the outcome of treatment.

RESULTS

Apnea hypopnea index (AHI) showed a reduction in the preoperative vs postoperative polysomnography (63.83 +/- 16.34 vs 21.43 +/- 20.34). With success defined as a final postoperative AHI of less than 20 events per hour, the success rate was 67%. The main differences between responders and nonresponders include age, posterior airway space (PAS), time of oxyhemoglobin saturation below 90% (CT90), and body mass index (BMI). Age and BMI were key predictors for therapeutic effect.

CONCLUSION

GAHM plus UPPP may benefit severe OSAHS patients with oropharyngeal and hypopharyngeal obstruction. The success was best predicted by low BMI and younger age.

SIGNIFICANCE

This paper provides reference for patient selection of UPPP plus GAHM, and considers that older or morbidly obese patients with OSAHS should be excluded from this operation.