Patton T J, Ogura J H, Thawley S E
Otolaryngol Head Neck Surg. 1984 Oct;92(5):509-19. doi: 10.1177/019459988409200503.
An inspiratory, circumferential, passive collapse of the hypopharyngeal lumen is the mechanism of airway obstruction in some patients with "idiopathic" obstructive sleep apnea syndrome. While permanent tracheotomy has resolved the obstruction and reversed the associated cardiopulmonary sequelae, it is not without complications. The expansion hyoidplasty was conceived as an alternative. The hyoid bone is trisected just medial to each lesser cornu, then held in an expanded position by a permanent brace. The greater cornua with attached middle constrictor and hyoglossus are moved laterally, while the body of the hyoid with attached geniohyoid and genioglossus shifts the base of tongue anteriorly. The procedure is potentially reversible. Twenty dogs were studied before and after hyoid expansion, 10 for superior hypopharyngeal pressure-volume measurements and 10 for the closing-pressure study. Pressure-volume studies demonstrated a consistent expansion of the superior hypopharynx. Deglutition and laryngeal competence wee not grossly affected. Reexamination of four animals in the closing-pressure group 1 year postoperatively demonstrated stability of the hyoid expansion and no evidence of serious parahyoid tissue complications.
下咽腔在吸气时呈环形被动塌陷，是一些“特发性”阻塞性睡眠呼吸暂停综合征患者气道阻塞的机制。虽然永久性气管切开术已解决了阻塞问题并逆转了相关的心肺后遗症，但并非没有并发症。扩张性舌骨成形术被设想为一种替代方法。在每个小角内侧将舌骨三等分，然后用一个永久性支架将其保持在扩张位置。附着有中间缩肌和舌骨舌肌的大角向外侧移动，而附着有颏舌骨肌和颏舌肌的舌骨体将舌根向前移动。该手术具有潜在的可逆性。对20只狗在舌骨扩张前后进行了研究，10只用于测量下咽上部的压力-容积，10只用于闭合压力研究。压力-容积研究表明下咽上部持续扩张。吞咽和喉部功能未受到严重影响。对闭合压力组的4只动物在术后1年进行复查，结果显示舌骨扩张稳定，且没有明显的舌骨旁组织并发症迹象。
