Hyoïdothyreoïdopexie als chirurgische behandeling van obstructief slaapapneusyndroom

To evaluate the results of hyoidothyroidopexy (HTP) in patients with obstructive sleep apnoea syndrome (OSAS).

Design

Prospective, descriptive.

Method

Data were collected on patients with moderate to severe OSAS that underwent HTP between 1 March 2000 and 30 June 2004 in the St. Lucas Andreas Hospital in Amsterdam. All patients had an obstruction at the level of the base of the tongue and, to a lesser degree, the palate and either refused the use of continuous positive airway pressure (CPAP) or were unable to tolerate this treatment. The following scores were calculated preoperatively and 3 months after the operation: the apnoea-hypopnoea index (AHI), apnoea index, Epworth sleepiness scale, desaturation index and visual analogue scores for hypersomnolence, snoring and pain sensation.

Results

During the period under investigation, 31 patients underwent HTP: 29 men and 2 women. Of these, 14 had never been operated before at the oral or hypopharyngeal level (average age: 47 years; average BMI: 26.3) and 17 had undergone unsuccessful uvulopalatopharyngoplasty (average age: 46.3 years; average BMI: 27.7). Of the 31 patients, 16 (52) had a significant decrease in the AHI, especially those in the primary HTP-group (10/14 or 71 vs. 6/17 or 35 in the secondary group, p > 0.05). The average AHI decreased from 32.9 to 11.9 (p = 0.006) in the primary group and from 31.5 to 26.2 (p = 0.06) in the secondary group. Most of the secondary outcome measures improved statistically significantly in both groups. In one patient, tracheotomy was performed due to postoperative bleeding that threatened to obstruct the respiratory tract.

Conclusion

The short-term results of HTP as the primary treatment in patients with moderate to severe OSAS could be characterised as favourable.

Ned Tijdschr Geneeskd. 2006;150:198-203