Abstract:ObjectiveTo study the influence of hyoid bone position in upper airway CT images on severity of obstructive sleep apnea hypopnea syndrome (OSAHS) and prognosis of modified uvulopalatopharyngoplasty (H-UPPP) via exploring the relationship between hyoid bone position and polysomnography (PSG) parameters and the prognosis of H-UPPP in OSAHS patients.MethodsPreoperative hyoid bone position in upper airway CT images and preoperative and postoperative PSG parameters of 47 OSAHS patients who underwent H-UPPP from June 2020 to Oct 2021 were collected. The vertical distance from the mandible menton to the lower margin of the hyoid bone (MH-v), the horizontal distance from the mandible mental spine to the hyoid bone (MH-h), and the Friedman tongue position (FTP) were conducted correlation analysis with apnea hypopnea index (AHI), lowest pulse oximeter oxygen saturation (LSpO2), average pulse oximeter oxygen saturation (AvSpO2) and the ratio of cumulative time of oxygen saturation below 90% to total sleep time (CT90) in PSG respectively. The correlations between MH-v or FTP and prognosis of H-UPPP were further analyzed.ResultsMH-v was moderately correlated with AHI, LSpO2 and AvSpO2 (r=0.540, P=0.000; r=-0.523, P=0.000; r=-0.514, P=0.000), MH-v was weakly correlated with CT90 (r=0.495, P=0.000). MH-h had no correlation with the above PSG parameters (P>0.05). FTP was weakly correlated with AHI, LSpO2, AvSpO2, and CT90(ρ=0.329, P=0.024;ρ=-0.309, P=0.034;ρ=-0.370, P=0.01;ρ=0.325, P=0.026). There was a statistically significant difference in MH-v between the effective and ineffective groups after H-UPPP (t=-5.908, P=0.000), while there was no statistically significant difference in FTP between the two groups (χ2=1.540, P=0.215). The area under receiver operator characteristic curve of MH-v was 0.884, which has moderate diagnostic value in predicting the effectiveness of H-UPPP surgery.ConclusionAs an anatomic factor affecting OSAHS patients, the MH-v has a higher correlation with PSG parameters than FTP, which is of certain value in predicting the effectiveness of H-UPPP surgery.
