Swan LogoHyoid Suspension

This procedure has been found to be an excellent adjunctive treatment for hypopharyngeal/base of tongue obstructive sleep apnea. The basic concept is that of connecting the hyoid arch to the thyroid cartilage (i.e. Adam's apple). The procedure is based on the conclusions made by Van de Graaf et al. that upper airway resistance (airway obstruction) was reduced by anterior movement of the hyoid.

Assessment chart

A number of muscles attached to the hyoid (i.e. hyoglossus, middle constrictor, geniohyoid, mylohyoid, anterior digastric, sternohyoid, and thyrohyoid) are important in maintaining upper airway patency during sleep. Expanding these pharyngeal dilators by moving the hyoid forward serves to open up the patient's airway. Additionally, the epiglottis is attached to the hyoid by way of the hyoepiglottic ligament. When the hyoid is moved forward and attached to the larynx, this moves the epiglottis forward and further opens the posterior air space.

Surgical diagram
Surgical diagram 2
Surgical diagram 3

 

After reviewing the numerous procedures designed to address snoring and obstructive sleep apnea, I am sure that you realize that no one procedure is a cure-all. Moreover, the topics thus far presented only deal with Phase I surgical approaches. Phase II surgery is infinitely more complex and is generally reserved for a very small percentage of difficult cases, in individuals, who otherwise would be using CPAP or need to be tracheotomized. As I inferred in an earlier section of this report, the truth is that if we didn't age, we all exercised regularly, maintained our ideal body weight, and didn't consume alcohol, the problem with snoring and obstructive sleep apnea would undoubtedly be very insignificant. Unfortunately, real life is far from ideal and therefore surgical and medical procedures have and will continue to be developed to help us breathe more comfortably at night.

Inferior sagittal osteotomy
Maxillary, mandibular and hyoid advancement

Additional treatments for snoring: The Pillar Palatal Implant System

For further information, or an appointment to be evaluated for snoring and obstructive sleep apnea, contact the Head and Neck Specialty Group of New Hampshire at (603) 692-4500.

Please download and complete our snoring questionnaire and bring it with you to your next appointment. Click HEREAdobe symbol to download.

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<--Page 4 Sleep Laboratory

To view the slide show
Diagnosis and Treatment of Snoring and Sleep Apnea
, click HERE

For information about the Pillar Palatal Implant System, click HERE

For information about our Sleep Laboratory , click HERE

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HEAD & NECK SPECIALTY GROUP OF NEW HAMPSHIRE
361 High Street Somersworth, NH 03878
John M. O'Day, M.D., F.A.C.S. Marjorie K. Stock, M.D. ,F.A.C.S.
William E. Long, Hearing Instrument Specialist
Telephone: 603-692-4500 Fax: 603-692-4520
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