Hyoid suspension is intended to stabilize the airway in the tongue region,
preventing obstructive airway collapse in this area. When it is combined
with a lateral pharyngoplasty, the average patient sees a 60% reduction
is their sleep apnea episodes.
Your doctor offers patients the best possible results while minimizing
risk by using the latest, most minimally invasive implants and techniques
in performing hyoid suspension.
The hyoid bone is a U-shaped bone in the neck located above the thyroid
cartilage (Adam’s apple) that has attachments to muscles of the
tongue as well as other muscles and soft tissues that surround the airway.
The hyoid bone is mobile and not firmly anchored in position. A hyoid
suspension repositions the hyoid bone towards the mandible which improves
the stability of the airway in this region.
Hyoid suspension is performed in the operating room under general anesthesia.
A small (usually 1.5-inch) skin incision is made in a natural skin crease
to camouflage the incision. Sutures are placed around the hyoid bone and
then tensioned and secured to bone screws placed behind the mandible.
The skin incision is then closed with sutures and skin adhesive.
The hyoid bone is pulled forward toward the mandible, stabilizing the airway
Hyoid Suspension Benefits
The benefits of hyoid suspension for treating obstructive sleep apnea include:
Safe and effective
- While any surgical implantation involves some risk, published clinical
studies have shown that hyoid suspension is safe and effective in reducing
obstructive sleep apnea severity.
Your doctor uses the
Encore system for hyoid suspension, which allows for the procedure to be performed through
a single, small incision with the operation typically completed in less
than an hour.
- While the recovery experience is different for every patient, since hyoid
suspension does not directly affect the soft tissues of the tongue and
tongue base, recovery from the procedure tends to be less painful than
other obstructive sleep apnea treatments that directly target the soft
tissue of the airway.
- In the rare case of persistent side effects or other post-treatment complications,
the hyoid suspension and all implantation materials can be easily removed.
Does not limit treatment options
- Hyoid suspension may be used with other sleep apnea medical therapies or
surgery techniques. It does not limit future treatment options if you
have progressive disease.
As with any surgery, there are risks, and results may vary from patient
to patient. Talk with your doctor about your specific condition to find
out if hyoid suspension is right for you.
As with any procedure, there is a risk of bleeding. To help avoid significant
bleeding, avoid the use of aspirin, NSAIDs (such as ibuprofen, Advil®,
Motrin®, naproxen, or Aleve®), vitamin supplements, or herbal
medications for at least two weeks before and after surgery.
Infection is rare but can occur if there is bleeding or drainage that accumulates
inside the wound. Patients should be vigilant in keeping the surgical
incision site clean.
Difficulty swallowing can occur after surgery due to a number of factors,
including generalized swelling in the area and structural changes produced
by the surgery. In the vast majority of cases, this is a transient problem.
Need for additional procedures
Hyoid suspension may not be effective in accomplishing the goals of surgery.
Additional airway procedures, performed on the tongue region or on another
area, may be necessary.
You should be prescribed narcotic pain medication after hyoid suspension.
Take this medication as you need it for pain control, and try not to let
the pain increase until it becomes intolerable before you take the medication.
If you prefer to avoid narcotics, you should feel free to use acetaminophen
(Tylenol®). Avoid aspirin, NSAIDs (such as ibuprofen, Advil®,
Motrin®, naproxen, or Aleve®), vitamin supplements, or herbal
medications for at least two weeks because they can increase your risk
of bleeding after surgery. Your pain will be significant for at least
the first three days following surgery, but if you had other procedures
performed at the same time the pain may be more severe.
Due to a combination of pain and swelling that is to be expected, you will
most likely have some trouble swallowing. This may be either a difficulty
in getting food to go down your throat or having liquids “go down
the wrong way” into your windpipe (trachea), with coughing as a
result. During your recovery, be careful with eating and drinking. Depending
on whether other procedures were performed at the same time as hyoid suspension,
you may only be able to tolerate a liquid diet for the first few days
after surgery. It is helpful to drink liquids other than water (such as
juices or Gatorade® and, especially, milk shakes or Ensure®) to
provide energy and protein during the recovery period. After this period
of time, you should transition to soft solid foods such as eggs or yogurt.
You should be able to tolerate a normal diet by 14 days following surgery.
You may be prescribed an antibiotic to take for several days. This can
be useful for preventing infection or decreasing swelling. Take the antibiotics
as directed. If you develop a rash or diarrhea (possible risks of antibiotics
and other medications), stop the antibiotics and contact your doctor immediately.
Minimize physical activity for four weeks
At a minimum, patients should walk at least three times a day starting
the day after surgery. Walking and spending more time out of bed (walking
or in a chair) rather than in bed are helpful because they reduce the
risks of developing pneumonia or blood clots in the legs. However, patients
should avoid strenuous activity because it typically raises heart rate
and blood pressure. For this reason, it can increase swelling or cause
bleeding to start.
Sleep with head elevated (at 45 degrees) for at least three days
Elevating your head during sleep decreases blood flow to the head and neck
regions, decreasing the swelling and associated pain from the procedure.
Elevating the head during sleep may also improve breathing patterns in
other ways. Therefore, we recommend elevating your head during sleep at
45 degrees for at least three days following the procedure.
NOTIFY YOUR DOCTOR IMMEDIATELY IF YOU HAVE ANY TROUBLE BREATHING OR IF
ANY BLEEDING DEVELOPS!