A Clinical Research Of The Therapeutic Effects Of Hyoid Suspension Plus Uvulopalatopharyngoplasty In Treating Moderate Or Severe OSAHS

Object We conducted the research to discuss the clinical effects of hyoid suspension(HS) plus uvulopalatopharyngoplasty(UPPP) in treating moderate or severe OSAHS(Obstructive Sleep Apnea Hypopnea Syndrome) with both obstructions.of palatopharyngeal plane and hyopharyngeal plane.Methods 30 patients with moderate or severe OSAHS who were hospitalized in the department of Otolarynpharyngology & Head and Neck Surgery of Yantai Yuhuang- ding Hospital of Qingdao University were included in the research.They were diagnosed by polysomnography(PSG),and Müller's test and X-ray projectile meas- urement were performed to confirm the existence of palatopharyngeal and hyopharyngeal plane obstruction.All patients underwent HS plus UPPP surgery,and were followed up to a year, and the postoperative complications,PSG and X-ray projectile measurement were used to evaluate the therapeutic effects.ResultsAll patients were were followed up to a year,and PSG and X-ray projectile measurement were performed.The preoperative and postoperative PSG results show that the preoperative AH,AI and AHI were significantly lowered than postoperative ones (P＜0.01),and the minimum SaO₂ also significantly increased than those prior to the operation(P＜0.01);their hyoid bones moved to higher and anterior positions compared to the preoperative positions.PAS increased significantly(P＜0.01).We evaluated the operation effect according to the standard set up in April 2002 by Otorhinolaryngology branch of China Medical Association.12 patients were classified as cured,the curing rate is 40.00%;and 10 were significantly effective,significantly effective rate is 33.33%;3 were effective,and effective rate is 10.00%;and 5 were ineffecitve,the ineffective rate is 16.67%;the total effective rate is 83.33%.The postoperation complications:all 30 patients complained about sore throat,and had difficulty swallowing with the climate during 2 to 4 days after the operations and after an average of 15 days,their bit and sup recovered.And the symptom can be relieved by using antibiotics and steroids;5 patients suffered from nasal cavity back- flow,and recovered a month later;Pharyngeal infection and smelly mouths were found in 2 cases and the symptom disappeared 3 days after antibiotic administering;3 days after the surgery 3 cases suffered from secondary bleeding because of bad cough and secondary operation were performed to ligate the bleeding points to stop bleeding;All patiens complained about stiff necks,which were caused by fabrication of hypodermal scars,and their necks recovered 6 months later;Yellow fluid flowed from the drainage hole a week after the operation in 2 patients,which is probably hypodermal fat liquefaction,and after two weeks of draining and binding the incision recovered;No lowered gestation,tongue dyscinesia or neck haematoma were found.Conclusions We can locate the obstructive plane by using Müiller's test and X-ray in clinical practice.HS can treat a part of OSAHS patients with cabined hyoidpharyngeal plane by enlarging the post airway gap tracting hyoid forward and upward,the long-term effect can be affirmative.HS plus UPPP is an safe,effective and easy operation in treating moderate or severe OSAHS patients with both obstructions palatopharyngeal and hyopharyngeal plane.