Determining Responders versus Non-Responders for Patients with Obstructive Sleep Apnea

by Thomas R. Collins •

Recommendations also included considering the lingual tonsils early and considering a hyoid myotomy and suspension with a retroverted epiglottis.

Additionally, Dr. Ishman said that sliding genioplasty is an option for retrognathic patients, and posterior midline glossectomy often can be done with a hyoid procedure to decrease tissue and open up the posterior airway space. “The airway evaluation is really critical in determining what to do for these cases,” Dr. Ishman said. “Sleep endoscopy can be very useful, and a view of the true vocal cords can really help you determine narrowing of the retroglottis.”

Take-Home Points

  • The tongue can play a major role in OSA, but other structures may contribute to airway obstruction.
  • Airway obstruction can be multi-layered and this can sometimes be missed.
  • Multi-level surgery is not recommended as a substitute for CPAP, because success of such surgery is often unpredictable.