Inferior Sagittal Osteotomy With Hyoid Bone Suspension for Obese Patients With Sleep Apnea

BACKGROUND: An inferior sagittal osteotomy with a sliding mandibular osteotomy and hyoid bone suspension, combined with a uvulopalatopharyngoplasty, is advocated in patients with obstructive sleep apnea who fail to tolerate nasal continuous positive airway pressure. Some investigators have suggested that this surgical procedure may be less effective 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 procedures. RESULTS: The mean +/- SD respiratory disturbance index during 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 morbidly obese patients (body mass index, > or = 33) had greater than a 50% reduction in the respiratory disturbance index after the surgical procedures were done. CONCLUSION: An inferior sagittal osteotomy with a sliding mandibular osteotomy and hyoid bone suspension, combined with a uvulopalatopharyngoplasty, tends to improve obstructive sleep apnea in obese patients.