Practical tips for hyoid suspension surgery

Hyoid suspension and myotomy is one of the procedures performed to treat obstructive sleep apnea. The main indication for the procedure is tongue base obstruction during drug-induced endoscopic (DISE) evaluation. Regardless of the technique used, hyoid suspension and myotomy can be categorized into two main techniques: hyoidthyroidpexia, where the hyoid bone is fixated to the thyroid cartilage, and hyomandibular suspension, where the hyoid is suspended to the mandible. Both aim to widen the hypopharyngeal airway and open the retrolingual space. The outcomes and risk of complication are generally better with hyomandibular suspension than the hyoidthyroidpexia. This chapter will discuss the pearls and pitfalls of hyoid suspension using the hyomandibular suspension technique.