Tongue suspension. (31st May 2013)

• Record Type: Journal Article
• Authors: Handler, Ethan; Hamans, Evert; Goldberg, Andrew N.; Mickelson, Samuel
• Is Part Of: Laryngoscope. Volume 124:Number 1(2014:Jan.)
• Page Start: 329
• Page End: 336
• Publication Date: 2013-05-31
• Subjects: Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.24187
• Languages: English
• ISSNs: 0023-852X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="lary24187-sec-0001" sec-type="section"> <title>Objectives/Hypothesis</title> <p>Our first objective was to perform a systematic review of suture‐based tongue suspension procedures as a stand‐alone therapy for hypopharyngeal obstruction in obstructive sleep apnea (OSA). A second objective compared outcomes of tongue suspension as part of a multilevel approach to OSA surgery to genioglossus advancement (GA) with uvulopalatopharyngoplasty (UPPP), and to genioglossus advancement with hyoid suspension (GAHM) with UPPP.</p> </sec> <sec id="lary24187-sec-0002" sec-type="section"> <title>Study Design</title> <p>Systematic review.</p> </sec> <sec id="lary24187-sec-0003" sec-type="section"> <title>Methods</title> <p>The PubMed database was queried for English‐language studies published after 1997 to create four cohorts: tongue suspension alone, tongue suspension with UPPP, GA + UPPP, and GAHM with UPPP. Chi‐squared test was used to compare outcomes between cohorts.</p> </sec> <sec id="lary24187-sec-0004" sec-type="section"> <title>Results</title> <p>Twenty‐seven studies were included, broken down into cohorts based on our selection criteria. Six studies qualified for the tongue suspension‐alone group with a surgical success rate of 36.6%. Eight studies qualified for our cohort of tongue suspension with UPPP with a surgical success rate of 62.3%. Eighteen studies qualified for our remaining two cohorts: GA + UPPP, and GAHM + UPPP. Their surgical success rates were both 61.1%. A chi‐squared test to compare surgical outcomes showed that there was no difference between tongue suspension with UPPP, GA + UPPP, and GAHM + UPPP.</p> </sec> <sec id="lary24187-sec-0005" sec-type="section"> <title>Conclusion</title> <p>Tongue suspension is effective and safe as part of a multilevel surgical approach for patients with OSA. As a stand‐alone procedure, its success rate is 36.6%, comparable to UPPP procedures for OSA success rates across the board. Tongue suspension should be considered in patients with OSA who demonstrate tongue base obstruction.</p> </sec> <sec id="lary24187-sec-0006" sec-type="section"> <title>Level of Evidence</title> <p>4. <italic>Laryngoscope</italic>, 124:329–336, 2014</p> </sec> </abstract>