Eur Arch Otorhinolaryngol (2011) 268:631–635 DOI 10.1007/s00405-010-1419-4 123 MISCELLANEOUS Complications of hyoid suspension in the treatment of obstructive sleep apnea syndrome Wietske Richard · Ferdinand Timmer · Harm van Tinteren · Nico de Vries Received: 13 August 2010 / Accepted: 25 October 2010 / Published online: 18 November 2010  Springer-Verlag 2010 Abstract The objectives of the study are to assess adverse events and complications of hyoid suspension (HS) as a treatment of obstructive sleep apnea syndrome (OSAS). The study design was cohort. Thirty-nine patients with OSAS and obstruction at tongue base level, as assessed by sleep endoscopy, underwent HS. Information about adverse events and complications were obtained by reviewing charts and patient-completed questionnaires. The mean follow-up period from surgery to last control visit was 13.1 months (range 2–38). The charts demonstrated mainly adverse events. Minor complications occurred in six patients. No major complications were observed. The mean admission duration was 3.3 days (range 2–5). Twenty-six patients (67%) returned their questionnaires. No association was found between completing questionnaires and the suc- cess of the intervention (p = 0.73). The questionnaires were completed on average 25.9 months (range 3.5–51.5) after surgery. VAS scores showed a fast decline in complaints regarding taste, speech, swallowing and pain. No signiW- cant long-term diVerences were found, when comparing the postoperative VAS scores with the preoperative VAS scores. Of the 26 evaluable questionnaires, 20 patients (77%) would recommend HS to an acquaintance if they suVered from sleep apnea syndrome, when only taking side eVects into consideration. The intention to give a positive recommendation did not seem to be related to the therapeu- tic success of the intervention. In conclusion, this study demonstrates that the complication rate of HS is low and that the discomfort is very acceptable. Keywords Obstructive sleep apnea syndrome · Hyoid suspension · Complications Introduction Obstructive sleep apnea syndrome (OSAS) is recognized as a disease with serious consequences. Besides a negative eVect on quality of life, such as severe snoring, daytime sleepiness and decreased intellectual performance [1, 2], OSAS is associated with increased risks of hypertension, myocardial infarction, stroke and traYc accidents [3–8]. The prevalence is estimated to be between 2 and 4% in middle-aged people [9]. OSAS is caused by an imbalance between the anatomy of the upper airway and the physiological loss of muscle tone during sleep, resulting in total breathing cessation (apneas) and/or airXow reduction (hypopneas). During the past decades, a variety of treatment modali- ties have been developed based on the diVerent elements of pathophysiology. These treatment methods can be classi- Wed as non-surgical or surgical therapies. Non-surgical therapies include lifestyle alterations, such as weight reduc- tion and abstinence of alcohol, sedatives and sleep medica- tion, nasal continuous positive airway pressure (NCPAP) and mandibular repositioning appliances (MRA) [10–13]. W. Richard (&) · N. de Vries Department of Otolaryngology/Head and Neck Surgery, St. Lucas Andreas Hospital, Jan Tooropstraat 164, Amsterdam 1061 AE, The Netherlands e-mail: w.richard@slaz.nl F. Timmer Department of Otolaryngology/Head and Neck Surgery, University Medical Centre, St. Radboud, Nijmegen, The Netherlands H. van Tinteren Department of Biostatistics, St. Lucas Andreas Hospital, Amsterdam, The Netherlands