INFERIOR SAGITTAL OSTEOTOMY WITH HYOID BONE SUSPENSION FOR OBESE PATIENTS WITH SLEEP-APNEA

Background: An inferior sagittal osteotomy with a sliding mandibular o steotomy and hyoid bone suspension, combined with a uvulopalatopharyng oplasty, is advocated in patients with obstructive sleep apnea who fai l to tolerate nasal continuous positive airway pressure. Some investig ators have suggested that this surgical procedure may be less effectiv e in obese patients. Methods: Preoperative and postoperative nocturnal polysomnograms and lateral cephalometric radiographs were obtained on 12 obese patients with obstructive sleep apnea who underwent these pr ocedures. Results: The mean +/- SD respiratory disturbance index durin g sleep decreased 53% +/- 11% after surgical procedures were performed (49 +/- 17 vs 23 +/- 11 events per hour, P < .001). Surgical outcome did not correlate with the body mass index, and 5 (71%) of 7 of the mo rbidly obese patients (body mass index, greater than or equal to 33) h ad greater than a 50% reduction in the respiratory disturbance index a fter the surgical procedures were done. Conclusion: An inferior sagitt al osteotomy with a sliding mandibular osteotomy and hyoid bone suspen sion, combined with a uvulopalatopharyngoplasty, tends to improve obst ructive sleep apnea in obese patients.