Hyoid and Tongue Advancement

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If the cause of your apneas (blocking of the airway) is from a collapse in the deep part of your throat or the back of your tongue falls back when you sleep, an additional procedure called a Hyoid Myotomy and Genioglossal Advancement Procedure may be performed. Typically these procedures are performed at the same time with a palatal reconstruction procedure.

Dr. Pasha is a consultant for this procedure through Medtronics’ AIRvance THS System. He has taught colleagues around the country a variation of his technique.

The procedure is in two parts: The Hyoid Suspension and The Tongue Suspension. Dr. Pasha may choose to perform a Hyoid Suspension without addressing the tongue or vice versa.

The operation begins with a small incision under the neck (usually in an area that is not visible). The hyoid bone, located above your Adam’s apple, is the only bone that does not connect to any other bone. Instead, the hyoid bone supports muscles that are connected to the back of the throat and tongue. Sutures are placed around the hyoid and brought forward toward your chin to give support to the muscles that support the back of the throat. This movement widens the airway in the deep throat. The suture is then tied to the inside of the jawbone with a small screw that you should never feel.

The tongue may then be “suspended.” By placing another stitch around the back of the tongue to prevent the base of the tongue from slipping back at night, like a hammock. You should not feel the suture.

pasha-diagram-hyoid-tongue-adv-01

pasha-diagram-hyoid-tongue-adv-02
Diagram of suspending the tongue using the AIRvance system.

FAQ

Dr. Pasha is quite proficient at hyoid and tongue suspension techniques. He is a consultant through Medtronics for this procedure. Although every case is different, he typically can complete both procedures within 20 minutes.

As a stand-alone procedure, this operation is well tolerated. Discomfort varies from patient to patient. If no other procedure is performed you may anticipate a few days of soreness around the incision site.

Not for the long term. For some, you may have 1-10 days of swallowing or speech issues. Typically, this resolves on its own.

If no other procedure is performed, a soft diet may be recommended for a few days before resuming a normal diet.

For the most part, Yes. Medicare typically covers the hyoid procedure as well as most private health plans. The tongue suspension is not always covered. Insurance coverage varies based on insurance providers, our center will help you check your specific situation to see what your insurance coverage may be.

If the procedure is covered, private health plans typically require Dr. Pasha‘s staff to submit paperwork for preauthorization of an elective surgery for obstructive sleep apnea.

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