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85th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

28.05. - 01.06.2014, Dortmund

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Hyoid suspension or laser surgery of lingual tonsils? A comparison of two treatments in multi-level surgery of obstructive sleep apnoea syndrome (OSA)

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  • corresponding author presenting/speaker Johannes Brus - Asklepios Klinik Harburg, Abteilung für HNO-Heilkunde, KHC, Hamburg, Germany
  • author Stefan Wenzel - Asklepios Klinik Harburg, Abteilung für HNO-Heilkunde, KHC, Hamburg, Germany
  • author Thomas Verse - Asklepios Klinik Harburg, Abteilung für HNO-Heilkunde, KHC, Hamburg, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 85th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Dortmund, 28.05.-01.06.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. Doc14hno17

doi: 10.3205/14hno17, urn:nbn:de:0183-14hno176

Published: July 24, 2014

© 2014 Brus et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

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Introduction: Moderately and severe OSA are treated with multi-level surgery. While treatment on soft palate is mostly uvulopalatopharyngoplasty combined with tonsillectomy or a modification, surgery on tongue base has different treatments depending on surgeon and local status.

Finding a hyperplasia of lingual tonsils we perform a laser surgery, otherwise a hyoid suspension type II meaning a hyoidothyreopexie in combination with radiofrequency surgery (RF) of tongue base.

Patients and methods: From 01/2010 to 11/2013 98 patients with OSA have been included in a prospective case-control study.

Preoperative patients underwent videoendoscopy under sedation. Preoperative and three month postoperative a complete standard polysomnography and elicitation of Epworth sleepiness scale (ESS) has been performed. Patients with AHI >30 did show CPAP- incompliance.

Results: Collective group did show an AHI postoperative 16.9 ± 15.8 (preoperative 33.9 ± 17.3). ESS had been reduced significant (10.8 ± 4.2 to 6.4 ± 3.6). Surgical success quotient by Sher was 58.1 %.

After laser surgery of lingual tonsils success quotient did show 59.6% (AHI pre 33.3 ± 14.3 vs. AHI post 17 ± 13.7) and after hyoid suspension combining RF the success rate was 56 % (AHI pre 32.7 ± 15.3 vs. AHI post 16.0 ± 13.5). There were no significant differences.

Complications were three bleeding events after tonsillectomy and one breakage of cerclage after hyoid suspension.

Summary: Results of both study arms are not significant and reflect results known from literature about MLS treating moderately and severe OSA. Choosing the operation procedure depending on local status of tongue base has been proved to be successful.