21685 Hyoid myotomy and suspension

Name of the Procedure:

Hyoid Myotomy and Suspension (also known as Hyoid Suspension)

Summary

Hyoid myotomy and suspension is a surgical procedure aimed at stabilizing the hyoid bone to improve airway function. The procedure involves cutting certain muscles and ligaments of the hyoid bone and then suspending the bone to a nearby structure to prevent airway obstruction.

Purpose

This procedure addresses obstructive sleep apnea (OSA) or severe snoring caused by the collapse of the lower throat (hypopharynx). The goal is to reduce airway collapsibility during sleep, leading to better oxygen flow and improved sleep quality.

Indications

• Moderate to severe obstructive sleep apnea not adequately managed by other treatments like CPAP (Continuous Positive Airway Pressure)
• Severe snoring affecting the quality of life
• Anatomical abnormalities of the hyoid bone contributing to airway obstruction
• Patients who have failed or are intolerant to conservative treatments

Preparation

• Patients may need to fast for at least 8 hours before the procedure.
• Adjustments to medications, especially blood thinners, as directed by the healthcare provider.
• Pre-operative sleep studies and imaging tests to assess airway anatomy.
• A physical examination and pre-surgical consultations to evaluate overall health.

Procedure Description

1. The patient is given general anesthesia to ensure they are asleep and pain-free.
2. An incision is made in the neck to access the hyoid bone.
3. Specific muscles and ligaments attaching to the hyoid bone are cut (myotomy).
4. The hyoid bone is then suspended to the thyroid cartilage or mandible using sutures or other fixation devices.
5. The incision is closed with stitches, and a dressing is applied.
6. The patient is monitored during the recovery from anesthesia.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

Hyoid myotomy and suspension is performed in a hospital or surgical center.

Personnel

• Surgeons, typically specializing in otolaryngology (ENT)
• Anesthesiologists
• Surgical nurses
• Operating room technicians

Risks and Complications

• Infection at the incision site
• Bleeding or hematoma formation
• Injury to surrounding structures like nerves or blood vessels
• Swelling and pain in the neck
• Anesthesia-related risks
• Dysphagia (difficulty swallowing)
• Limited improvement in sleep apnea symptoms

Benefits

• Improved airway function during sleep
• Reduction in sleep apnea episodes
• Less reliance on CPAP or other conservative treatments
• Enhanced quality of life and daytime functioning

Recovery

• Pain management using prescribed medication
• Instructions to keep the incision site clean and dry
• Avoid strenuous activities for a few weeks
• Follow-up appointments to monitor healing and effectiveness of the procedure
• Full recovery typically takes several weeks, but patients may notice improvement in symptoms within a few days.

Alternatives

• Continuous Positive Airway Pressure (CPAP) therapy
• Oral appliances designed to keep the airway open during sleep
• Other surgical options such as uvulopalatopharyngoplasty (UPPP) or genioglossus advancement
• Lifestyle modifications like weight loss and positional therapy

Patient Experience

• The patient will likely experience neck pain and swelling post-procedure, which can be managed with medication.
• Swallowing may be uncomfortable for several days.
• A noticeable improvement in breathing and sleep quality might be felt within days to weeks.
• Regular follow-ups to ensure proper healing and effectiveness of the surgery.