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At the 1988 annual meeting of the American Academy of Otolaryngology–Head and Neck Surgery in Washington, DC, Robert W. Riley and colleagues, Palo Alto, Calif, presented a new technique for the management of obstructive sleep apnea. Relying on their experience and that of others, they concluded that there were a number of uvulopalatopharyngoplasty failures as a result of pharyngeal obstruction, and that these patients could be helped by a mandibular osteotomy and hyoid suspension procedure. With these techniques, they showed that they could increase the "responders," patients with a respiratory disturbance index less than 20%, from less than 50% to 67%. Those patients who did not respond were noted to have a structural deficiency, and, if they were treated with a maxillary, mandibular, and hyoid advancement procedure, they could affect a further reduction in signs and symptoms. Several patients in their series who had failed palatopharyngoplasty were helped with the
MATHOG H. Maxillofacial Surgery and Obstructive Sleep Apnea: A Review of 80 Patients. Arch Otolaryngol Head Neck Surg. 1989;115(4):421. doi:10.1001/archotol.1989.01860280015002
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