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Hyoid expansion with titanium plate and screws with hyomandibular suspension: A study on human cadavers with computed tomographic comparative analysis
OBJECTIVE(S): Obstructive sleep apnoea is characterized by repetitive obstruction of the upper airway during sleep. These repeated oxygen desaturations increase cardiovascular and cerebrovascular morbidity and mortality significantly. Upper airway surgery is an option for patients who fail continuou...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley & Sons, Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7752091/ https://www.ncbi.nlm.nih.gov/pubmed/33364417 http://dx.doi.org/10.1002/lio2.476 |
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author | Ng, Adele Chin Wei Salkade, Parag Ratnakar Rangabashyam, Mahalakshmi Loh, Shaun Ray Han Toh, Song Tar |
author_facet | Ng, Adele Chin Wei Salkade, Parag Ratnakar Rangabashyam, Mahalakshmi Loh, Shaun Ray Han Toh, Song Tar |
author_sort | Ng, Adele Chin Wei |
collection | PubMed |
description | OBJECTIVE(S): Obstructive sleep apnoea is characterized by repetitive obstruction of the upper airway during sleep. These repeated oxygen desaturations increase cardiovascular and cerebrovascular morbidity and mortality significantly. Upper airway surgery is an option for patients who fail continuous positive airway pressure therapy. Airway collapse is usually multilevel and hypopharyngeal collapse is a challenging area to address. It is hypothesized that hyoid expansion with hyomandibular suspension can potentially increase upper airway dimensions at the hypopharynx. This study aims to document the effect of hyoid expansion using titanium plate and screws with hyomandibular suspension on hypopharyngeal airway dimensions. It is an anatomical feasibility study performed using 10 human cadaver heads. METHODS: The hyoid bone is trifractured. The expanded hyoid is then suspended to the mandible. Computed tomography (CT) scans were performed on the cadavers to measure the airway dimensions before and after the procedure. RESULTS: This procedure resulted in statistically significant increase in airway dimensions at the level of the hypopharynx in all 10 human cadaver heads. Increase in cross‐sectional area correlated significantly with increase in 3‐dimentional (3D) volume. The mean area of the airway at the level of the hyoid increased from 999.3 ± 193.0 mm(2) to 1241.4 ± 103.2 mm(2). Statistically significant increase in upper airway volume based on 3D reconstruction was also noted. Upper airway volume increased from 6.94 ± 6.46 mL to 13.58 ± 8.29 mL. CONCLUSION: Airway dimensions increased with hyoid expansion and hyomandibular suspension in our cadaveric study measured using CT scans. Further studies are needed to see if this technique can be translated to clinical use in live patients. LEVEL OF EVIDENCE: NA. |
format | Online Article Text |
id | pubmed-7752091 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley & Sons, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-77520912020-12-23 Hyoid expansion with titanium plate and screws with hyomandibular suspension: A study on human cadavers with computed tomographic comparative analysis Ng, Adele Chin Wei Salkade, Parag Ratnakar Rangabashyam, Mahalakshmi Loh, Shaun Ray Han Toh, Song Tar Laryngoscope Investig Otolaryngol Sleep Medicine and Science OBJECTIVE(S): Obstructive sleep apnoea is characterized by repetitive obstruction of the upper airway during sleep. These repeated oxygen desaturations increase cardiovascular and cerebrovascular morbidity and mortality significantly. Upper airway surgery is an option for patients who fail continuous positive airway pressure therapy. Airway collapse is usually multilevel and hypopharyngeal collapse is a challenging area to address. It is hypothesized that hyoid expansion with hyomandibular suspension can potentially increase upper airway dimensions at the hypopharynx. This study aims to document the effect of hyoid expansion using titanium plate and screws with hyomandibular suspension on hypopharyngeal airway dimensions. It is an anatomical feasibility study performed using 10 human cadaver heads. METHODS: The hyoid bone is trifractured. The expanded hyoid is then suspended to the mandible. Computed tomography (CT) scans were performed on the cadavers to measure the airway dimensions before and after the procedure. RESULTS: This procedure resulted in statistically significant increase in airway dimensions at the level of the hypopharynx in all 10 human cadaver heads. Increase in cross‐sectional area correlated significantly with increase in 3‐dimentional (3D) volume. The mean area of the airway at the level of the hyoid increased from 999.3 ± 193.0 mm(2) to 1241.4 ± 103.2 mm(2). Statistically significant increase in upper airway volume based on 3D reconstruction was also noted. Upper airway volume increased from 6.94 ± 6.46 mL to 13.58 ± 8.29 mL. CONCLUSION: Airway dimensions increased with hyoid expansion and hyomandibular suspension in our cadaveric study measured using CT scans. Further studies are needed to see if this technique can be translated to clinical use in live patients. LEVEL OF EVIDENCE: NA. John Wiley & Sons, Inc. 2020-10-21 /pmc/articles/PMC7752091/ /pubmed/33364417 http://dx.doi.org/10.1002/lio2.476 Text en © 2020 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC. on behalf of The Triological Society. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Sleep Medicine and Science Ng, Adele Chin Wei Salkade, Parag Ratnakar Rangabashyam, Mahalakshmi Loh, Shaun Ray Han Toh, Song Tar Hyoid expansion with titanium plate and screws with hyomandibular suspension: A study on human cadavers with computed tomographic comparative analysis |
title | Hyoid expansion with titanium plate and screws with hyomandibular suspension: A study on human cadavers with computed tomographic comparative analysis |
title_full | Hyoid expansion with titanium plate and screws with hyomandibular suspension: A study on human cadavers with computed tomographic comparative analysis |
title_fullStr | Hyoid expansion with titanium plate and screws with hyomandibular suspension: A study on human cadavers with computed tomographic comparative analysis |
title_full_unstemmed | Hyoid expansion with titanium plate and screws with hyomandibular suspension: A study on human cadavers with computed tomographic comparative analysis |
title_short | Hyoid expansion with titanium plate and screws with hyomandibular suspension: A study on human cadavers with computed tomographic comparative analysis |
title_sort | hyoid expansion with titanium plate and screws with hyomandibular suspension: a study on human cadavers with computed tomographic comparative analysis |
topic | Sleep Medicine and Science |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7752091/ https://www.ncbi.nlm.nih.gov/pubmed/33364417 http://dx.doi.org/10.1002/lio2.476 |
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