Comparing Hyoid Suspension Approaches in Multilevel Sleep Surgery: A Systematic Review and Meta‐Analysis

Database searches yielded 1502 studies with 74 full-text articles screened, and 21 studies ultimately included. In patients who underwent hyothyroidpexy and palatal surgery (n = 582), the average AHI was reduced 20.98 (confidence interval 16.87, 25.08), ESS score improved by 5.99 [4.35, 7.63], and 57.5% met Sher criteria for surgical success. Patients who received hyomandibular suspension (n = 141) achieved an average AHI reduction of 29.21 [20.87, 37.55], improvement in ESS by 4.4 [1.33, 7.51], and Sher success rate of 73.8%. Although improvement in AHI and ESS scores were not statistically significant between groups, the proportion of patients meeting Sher Criteria success was greater for hyomandibular suspension (P = .006) CONCLUSION: 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 suggests that hyomandibular suspension may provide greater improvement than hyothyroidpexy.