Hyoid Suspension

You must first undergo a medical evaluation to review your past sleep study records, medical history and in many cases have a diagnostic evaluation with a drug induced sleep endoscopy (DISE).

While hyoid suspension surgery can effectively treat obstructive sleep apnea, it is typically reserved for patients who have not responded to other treatments, such as continuous positive airway pressure (CPAP) therapy or oral appliances.

Some patients have a significant base of tongue, epiglottis and lower airway (hypopharyngeal) collapse.

Patients with obstructive sleep apnea typically have one of two major palate abnormalities on their DISE exam: collapsing in a circumferential or back-to-front (anterior-posterior) fashion.

• Patients with anterior-posterior collapse are good candidates for an Inspire procedure.
• For patients with circumferential collapse, hyoid suspension surgery is one of a few different treatment options.

Hyoid suspension can also be used in certain cases of anterior-posterior collapse depending on the airway.

• Hyoid suspension is performed in the operating room under general anesthesia.
• During the procedure, your surgeon will make a small incision in the upper neck, exposing the hyoid bone.
• Two small screws are placed in the jaw and a suture is passed around the hyoid and tightened to the screws. This allows the airway to be pulled forward and stabilized.

After surgery, patients are kept overnight for observation and pain control. Your care team will give you clear, detailed care instructions and an appointment will be scheduled one week after surgery.

• You should expect to be off work for about one to two weeks and no heavy lifting or vigorous activity for two weeks.
• During this time, you will be provided pain medication.
• Eat a soft diet during this time. Protein shakes are a helpful nutrition supplement.
• It is important to monitor for any bleeding or neck swelling. If this occurs go to the emergency room for evaluation.

Additional appointments will be scheduled one month after surgery and again at three months for additional testing. Once effective treatment is confirmed, patients typically follow up once a year to ensure their sleep apnea symptoms are not returning and no new issues are arising.

Pain is usually well tolerated after this surgery and is less than in a typical tonsillectomy. You will receive adequate pain medication in the postoperative period. At your one-week follow-up appointment, your physician can help you address any issues with your recovery.

The surgical changes are permanent and designed to last for years. However, weight changes can affect anatomy. The system is removable if necessary.

You must refrain from heavy lifting for two weeks post-surgery to prevent complications. After that, you may return to all normal activities, including sports.

Expect your neck to feel tight for a month or two after the surgery. This is intentional to better support the airway. This sensation should pass slowly with time.