Sleep Apnea Surgery Service, Department of Otolaryngology-Head and Neck Surgery, Singapore General Hospital, Singapore.
JAMA Otolaryngol Head Neck Surg. 2013 Aug 1;139(8):817-21. doi: 10.1001/jamaoto.2013.3906.
Hyoid expansion with suspension can potentially increase the upper airway at the hypopharyngeal level, benefitting patients with sleep-related breathing disorder.
To document the effect of hyoid expansion using titanium plate and screw on retrolingual hypopharyngeal airway dimension and to compare the airway dimension after isolated hyoid expansion with hyoid expansion + hyomandibular suspension.
Anatomical cadaveric dissection study.
This study was performed in a laboratory setting using human cadavers.
This is an anatomical feasibility study of hyoid expansion using titanium plate and screw on 10 cadaveric human heads and necks. The hyoid bone is trifractured with bony cuts made just medial to the lesser cornu. The freed hyoid body and lateral segments are expanded and stabilized to a titanium adaptation plate. Computer-assisted airway measurement (CAM) was used to measure the airway dimension at the hypopharynx at the level of the tongue base before and after the hyoid expansion. The expanded hyoid bone was then suspended to the mandible, and the airway dimension was measured again with CAM.
Airway dimension after isolated hyoid expansion with hyoid expansion with hyomandibular suspension. RESULTS Hyoid expansion with titanium plate and screw resulted in statistical significant increase in the retrolingual hypopharyngeal airway space in all of the 10 human cadavers. The mean (SD) increase in retroglossal area was 33.4 (13.2) mm² (P < .005) (range, 6.0-58.7 mm²). Hyoid expansion with hyomandibular suspension resulted in a greater degree of airway enlargement. The mean (SD) increase in retroglossal area was 99.4 (15.0) mm² (P < .005) (range, 81.9-127.5 mm²).
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.
舌骨扩张伴悬吊术可潜在增加下咽水平的上气道，有益于睡眠呼吸障碍相关患者。
记录钛板和螺钉舌骨扩张对舌根后咽气道尺寸的影响，并比较单纯舌骨扩张与舌骨扩张+舌颌骨悬吊后的气道尺寸。
解剖尸体研究。
本研究在实验室环境中使用人体尸体进行。
这是一项使用钛板和螺钉对 10 个人体头颈部进行的解剖可行性研究。将舌骨三骨折，在小角内侧做骨切开。游离的舌骨体和外侧段扩张并固定在钛制适应板上。计算机辅助气道测量（CAM）用于测量舌骨扩张前后舌根下咽水平的气道尺寸。然后将扩张的舌骨骨悬吊到下颌骨，再次使用 CAM 测量气道尺寸。
单纯舌骨扩张和舌骨+舌颌骨悬吊后的气道尺寸。
钛板和螺钉舌骨扩张使所有 10 个人体尸体的舌根后咽气道空间均有统计学显著增加。舌骨后区的平均（SD）增加量为 33.4（13.2）mm²（P <0.005）（范围，6.0-58.7 mm²）。舌骨+舌颌骨悬吊后的气道扩张程度更大。舌骨后区的平均（SD）增加量为 99.4（15.0）mm²（P <0.005）（范围，81.9-127.5 mm²）。
在我们的人体尸体研究中，使用 CAM 测量，钛板和螺钉舌骨扩张增加了舌根后咽气道空间，并且增加程度随舌颌骨悬吊进一步增强。
