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Scientific Oral Presentations

Sleep Medicine

Session: Scientific Oral Presentation 3 - Sleep

Hyomandibular vs Hyothyroid Suspension: A Systematic Review and Meta-analysis of Hyoid Suspension Approaches

Monday, October 13, 2025
10:06 AM - 10:12 AM EDT
Location: 136
Disclosure(s):
Joel James, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Marion B. Gillespie, MD, MSc:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Hyoid suspension (HS) is a method used to address hypopharyngeal obstruction in multilevel sleep surgery for obstructive sleep apnea (OSA) that is significantly less invasive than many of alternative hypopharyngeal procedures. In this procedure, the hyoid bone is suspended to either the mandible or thyroid cartilage. Approach is usually determined by surgeon preference as there is limited data comparing the outcomes of HS methods. This meta-analysis aims to compare the effectiveness of these two approaches to HS in treating OSA.

Methods: This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. PubMed, Scopus, Cochrane, and Embase were searched up to December 2024 for studies containing patients who underwent HS to either the thyroid or mandible with concurrent palatal surgery and without concurrent major hypopharyngeal procedures such as genioglossus advancement, midline glossectomy, or maxillomandibular advancement. Primary outcomes included pre- and postoperative apnea hypopnea index (AHI) and surgical success rate per the Sher criteria (≥50% reduction in AHI and postoperative AHI < 20).

Results: Database searches yielded 1102 studies and 100 of these met criteria for screening. 21 studies containing 846 patients were included. 659 patients underwent hyothyroid suspension and palatal surgery; the average AHI in this group was reduced from a preoperative value of 37.7 to 18.6 postoperatively for an average reduction of 50.1% (MD 19.3, 95% CI 14.4-24.1). 58.2% (95% CI 49%-66%) of patients in this group met Sher criteria for surgical success. The remaining 187 patients received hyomandibular suspension and results showed a reduction in average AHI from 55.3 to 19.9 for an average reduction of 64% (MD 35.3, 95% CI 29.15- 41.5) with a Sher success rate of 72.5% (95% CI 65%-81%).

Conclusions: The results of this study show that both methods of hyoid suspension are effective in treating OSA when used as a component of multilevel sleep surgery but suggest that hyoid suspension to the mandible may provider greater improvement than hyoid suspension to the thyroid.

    Presenting Author(s)

  • JJ

    Joel James, MD

    Resident Physician
    University of Tennessee Health Science Center
    Memphis, TN, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Emily R. Baker, MD

    Resident Physician
    Vanderbilt University Medical Center
    Memphis, Tennessee, United States

    Disclosure information not submitted.

    • Co-Author(s)

  • Harrison P. Smith, BA

    Medical Student
    University of Tennessee Health Science Center
    Memphis, TN, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • MG

    Marion B. Gillespie, MD, MSc

    Professor and Chair
    UTHSC
    Memphis, Tennessee, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.