Published clinical experience with hyoid suspension can be summarized into three different approaches to the hyoid suspension procedure : hyo-mandibular suspension, hyo-thyroid suspension, and genioglossus advancement and hyoid myotomy.
22.
When there is a more severe upper lid retraction or exposure keratitis, marginal myotomy of levator palpebrae associated with lateral M�ller muscle ), eyelid spacer grafts, and recession of the lower eyelid retractors.
23.
Autopsy and myotomy specimens have, on histological examination, shown an inflammatory response consisting of CD3 / CD8-positive cytotoxic T lymphocytes, variable numbers of eosinophils and mast cells, loss of ganglion cells, and neurofibrosis; these events appear to occur early in achalasia.
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