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Abstract The unsatisfactory results of UPPP and its modification in the treatment of snoring and sleep apnea were disappointing. The recurrence of symptoms increased with the longer follow up. The bad impressions of the results of these operations were due to missing of other levels of collapse. The commonest site of collapse after the retropalatal area is the base of the tongue, which produce narrowing of the retrolingual area during sleep Hyoid suspension and laser midline glossectomy were designed to prevent its collapse. The study concerned to discuss these two types of surgeries. Hyoid suspension suspension as example of stabilizing operation of the base of the tongue to prevent its collapse during sleep. Midline laser glossectomy was another example for reduction surgery to reduce the size of the obstructive part of the tongue. The results of both surgeries were significant in reducing the OSA. The improvement in (AHI) more than 50 % is considered as a responder to surgery. The responder patients in hyoid suspension technique were 66.67% and non-responder patients were 33.33% but in midline laser glossectomy responder patients were 53.3% and nonresponder patients were 46.7% In hyoid suspension operation the reduction of the mean of (AHI) in responders was 77.2% and in non-responders was 36.2% but in midline laser glossectomy the reduction of AHI in responders was 73.9% and in non-responders was 40.8%. Summary 137 In this study: Hyoid suspension procedure appeared to be more efficient than laser midline glossectomy in controlling OSA. Laser midline glossectomy had significant peri-operative morbidity, immediately peri-operatively significant pain, and dysphagia occurred. Various methods were used to minimize morbidity (pain and swallowing difficulties) with corticosteroids and non steroidal antiinflammatory medications. Hyoid suspension is expensive if done by Repose screw system (Devices included is about 8000 L.E.). However a simple, economic modification of hyoid suspension was demonstrated in this study. The advantages of hyoid suspension are: 1-Safe and effective: Hyoid suspension is safe and effective in reducing obstructive sleep apnea severity. 2- Minimally invasive: Through a single, small incision with the operation typically completed in less than an hour. 3-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. Summary 138 4-100% 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. 5-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. |