Genioglossus advancement and hyoid suspension plus uvulopalatopharyngoplasty for severe OSAHS.

OBJECTIVE: To evaluate the outcome of a comprehensive surgical approach on the treatment of severe obstructive sleep apnea hypopnea syndrome (OSAHS) and find out possible predictors to the effectiveness of this approach. STUDY DESIGN AND SETTING: Eighteen patients received genioglossus advancement with hyoid suspension (GAHM) and uvulopalatopharyngoplasty (UPPP). The multiple logistic regression was used to analyze predictors for the outcome of treatment. RESULTS: Apnea hypopnea index (AHI) showed a reduction in the preoperative vs postoperative polysomnography (63.83 +/- 16.34 vs 21.43 +/- 20.34). With success defined as a final postoperative AHI of less than 20 events per hour, the success rate was 67%. The main differences between responders and nonresponders include age, posterior airway space (PAS), time of oxyhemoglobin saturation below 90% (CT90), and body mass index (BMI). Age and BMI were key predictors for therapeutic effect. CONCLUSION: GAHM plus UPPP may benefit severe OSAHS patients with oropharyngeal and hypopharyngeal obstruction. The success was best predicted by low BMI and younger age. SIGNIFICANCE: This paper provides reference for patient selection of UPPP plus GAHM, and considers that older or morbidly obese patients with OSAHS should be excluded from this operation.