TABLE IX.D.5.d.
Evidence on hyoid suspension for OSA
| Study | Year | LOE (1A-5) | Study design | Study groups | Clinical endpoint | Conclusion |
|---|---|---|---|---|---|---|
| Kezirian1802 | 2006 | 2a | Systematic review of retrospective studies | 1. HS (4 studies, n = 101) 2. HS + GA and palate surgery (7 studies, n = 328) |
AHI EDS |
1. Preop AHI: 32–48, Postop: 15–37. Sig decrease in 2/4 studies. 17%–78% success. EDS with sig decrease in ¾ studies. 2. Preop AHI: 27–71, Postop: 10–57. Sig decrease in 2/7 studies. 18%–77% success. EDS with sig decrease in ¾ studies. |
| Verse1670 | 2015 | 2a | Prospective controlled clinical trial | UPPP with 1. Lingual tonsillectomy (n = 58) 2. HS+RFA (n = 50) |
AHI | 1. Mean AHI preop: 35, AHI postop: 17, 59% success. ESS decreased from 10 to 6, (p < 0.001). 2. Mean AHI preop: 50, AHI postop: 29, 54% success. ESS decreased from 12 to 8, (p < 0.001) No significant difference between groups. |
| Verse1824 | 2006 | 2b | Prospective cohort study |
Multilevel surgery 1. With HS (n = 23) 2. Without HS (n = 12) |
AHI ESS |
1. Mean preop AHI: 39, postop: 21, (p < 0.001). ESS decreased from 9 to 7, (p < 0.05). 2. No significant decrease in AHI. ESS showed decrease from 9 to 4, (p < 0.05). |
| Song1804 | 2016 | 2a | Systematic review and metaanalysis | Isolated HS (9 studies, n = 101) | AHI ESS |
Mean AHI reduced 38% from 37 to 23 (p < 0.001). 7%–83% reduction in AHI Mean ESS decrease from 10 to 3 (p < 0.003). |
| Askar1825 | 2019 | 4 | Case series | DISE confirmed hypopharyngeal collapse (n = 21) | AHI | Mean AHI decreased from 48 to 12, (p < 0.001). |
Success based on Sher’s criteria = reduction in AHI ≥ 50% with final AHI < 20/h.
Abbreviations: AHI: apnea hypopneaiIndex; DISE = drug-induced sleep endoscopy; EDS = Excessive daytime sleepiness; ESS = Epworth sleepiness scale; HS = hyoid suspension; RFA = radiofrequency ablation; Sig = signficant