Open AccessPulling on Hyoid Reduces Airway Collapse in Human Cadavers
Author(s) -
Rosenbluth Kathryn H.,
Kwait Dillon,
Harrison Michael,
Kezirian Eric J.
Publication year - 2011
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599811415823a462
Subject(s) - hyoid bone , airway , cadaver , medicine , anatomy , airflow , fluoroscopy , orthodontics , surgery , physics , thermodynamics
Objective This study examined the changes in upper airway dimensions and collapsibility associated with force applied to the hyoid bone using a suture and a novel magnetic system (internal magnet secured to the hyoid and external magnet) in un‐fixed human cadavers. Method Eight cadavers were tested with traction on the hyoid using 1) suture around the hyoid to apply 0.5‐5 Newtons of force and 2) a novel magnetic system. Changes in airway dimensions were measured with fluoroscopy and 3‐dimensional computed tomography reconstructions. Airway collapsibility was measured using a previously‐described flow‐based model. Results A 2N (0.5 lb) force applied to the hyoid bone increased airway dimensions, with greatest effect in the retrolingual region. The anterior direction of traction was more effective than inferior or superior. There was a linear association between the magnitude of force and critical airflow, at 1.5L/min/N (R 2 = 0.75). All magnitudes of pull increased the critical airflow ( P <. 001). At 2N, the hyoid was advanced 1cm, and the critical airflow was increased 3‐fold (3.0 ± 1.71L/min). The magnet system showed similar airway effects to the direct 2N applied force. An increase in upper airway dimensions occurred with inter‐magnet distances of 2cm. Conclusion Forces applied to the hyoid improve upper airway dimensions and collapsibility in the human un‐fixed cadaver model. A novel magnet system may represent a promising therapy for treatment of upper airway obstruction in disorders such as obstructive sleep apnea.