Tongue base suspension procedures for obstructive sleep apnea syndrome

It is generally accepted that obstructive sleep apnea syndrome (OSA) results from the combination of a structurally small upper airway and abnormal airway collapsibility during sleep. Treatment of OSA, therefore, is directed at preventing airway collapse. For those patients who do not respond to conservative medical management such as positional therapy and weight loss, or are unable to tolerate or comply with positive pressure ventilation (continuous positive airway pressure, bilevel positive airway pressure, and other modalities) or mandibular advancement devices, surgical intervention remains the last option. Surgical treatments that target tongue base and hypopharyngeal collapse traditionally included partial glossectomy, midline glossectomy, linguoplasty, mandibular osteotomy with genioglossus advancement, and maxillary-mandibular advancement. Many of these procedures are associated with extreme morbidity and are not readily accepted by patients as treatment options. In search of minimally invasive alternatives, otolaryngologists began looking at other potential methods of anterior displacement and stabilization of the base of tongue.