A Prospective Cohort Study of Aesthetic Outcomes Following Hyoid Myotomy and Suspension for Obstructive Sleep Apnea

ABSTRACT Objective To evaluate subjective and objective submental/neck aesthetic outcomes after hyoid myotomy and suspension (HMS) performed for obstructive sleep apnea (OSA). Methods Single‐blind, single‐center, prospective cohort study including 20 adults undergoing HMS (active) and 11 adults undergoing septoplasty (control) between July 2020 and November 2022. Participants completed FACE‐Q Neck and Area Under Chin modules and underwent standardized frontal and lateral photography preoperatively and 6 weeks postoperatively. Primary outcomes were change in cervicomental angle (CMA), hyomental distance (HMD), Rainbow Scale (RS), and FACE‐Q scores; frontal neck width was a secondary outcome. Between‐group differences in change were assessed using ANCOVA adjusting for age and baseline values. Results HMS participants were older than controls (median 67 [IQR 54–74] vs. 47 [35–56] years; p = 0.021). In adjusted analyses, HMS demonstrated greater improvement than controls in FACE‐Q Area Under Chin (adjusted mean difference + 17.48; 95% CI, 2.2 to 32.8; p = 0.022), FACE‐Q Neck (+14.60; 95% CI, 2.1 to 27.2; p = 0.025), and CMA (−10.17°; 95% CI, −19.4 to −1.0; p = 0.026). Differences were not significant for RS (−0.36; p = 0.311), HMD (−0.69 cm; p = 0.095), or neck width (−0.20 cm; p = 0.547). Conclusion In this feasibility cohort with 6‐week follow‐up, HMS for OSA was associated with improved patient‐reported aesthetic satisfaction and a greater reduction in CMA compared with septoplasty controls. Larger studies with longer follow‐up are needed to assess durability and longer‐term outcomes. Level of Evidence 3.