Tom base obstruction is a common sight of collapse in patients with obstructive sleep apnea. The genioglossus bone advancement is an effective method of treating collapse upper tongue base. However, obstruction lower in the throat just above the larynx (voice box) has been more difficult to treat. The hyoid bone in the offer midline of the neck is attached to this area. By bringing this bone attached to the muscles of the lower tongue base improves this area of collapse.
The hyoid bone is advanced and brought forward by suspension from the anterior mandible (front of jaw). This is performed by making a 2 inch horizontal incision in a skin crease in the upper midline of the neck. A special screw inserter is passed through this incision and two small screws attached to monofilament line are placed on the inner surface of the mandible. The two small screws measuring one quarter of an inch are placed on either side of midline. The loops of the monofilament line are threaded on either side of the hyoid bone. By tightening the two loops the hyoid is effectively suspended from the mandible improving thearea of obstruction.
This procedure performed in conjunction with the UPPP and genioglossus bone advancement has shown a success rate of 70%. Success is defined as decreasing the AHI by 50% or lowering the AHI below 20.
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