Genioplasty for genioglossus muscle advancement in patients with obstructive sleep apnea-hypopnea syndrome and mandibular retrognathia

颏成形术用于治疗阻塞性睡眠呼吸暂停低通气综合征和下颌后缩患者的颏舌肌前移

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Abstract

Obstructive sleep apnea syndrome is a complex disease, which the etiology is multifactorial and incompletely understood. Surgery with genioglossus advancement is indicated in hypopharynx obstruction. AIM: evaluate the efficacy and complications of genioplasty technique for genioglossus muscle advancement in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). METHODS: polysomnography, physical examination and cephalometric analysis were performed in 10 non-obese patients, who presented mild or moderate OSAHS, an apnea-hypopnea index (AHI) between 5 and 30, with hypopharynx obstruction and mandibular retrognathia. RESULTS: the AHI preoperative mean of 12.4+/-4.6 decreased to a postoperative mean of 4.4+/-5.7 (p < 0,001). When 50% reduction of preoperative AHI was chosen as a parameter, its rate was 70% (7/10). Cephalometric analysis revealed an increase in the posterior airway space (PAS) in all patients, from a preoperative mean value of 7.9+/-2.3mm to a postoperative mean value of 10.8+/-2.5mm (p < 0,001). CONCLUSION: genioplasty for genioglossus advancement seemed to reduce OSAHS signs, thus, it can be considered as an option for the surgical treatment of patients with hypopharynx obstruction. Data collected supports this surgical procedure as an option in patients with OSAHS and mandibular retrognathia.

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