Hyoid Suspension

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.

Minimally invasive

• 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.

Improved recovery

• 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.

100% reversible

• 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.

Risks

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.

Bleeding

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

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.

Trouble swallowing

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.

Postoperative Instructions

Pain control

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.

Diet

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.

Antibiotics

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!