Skip to main content
SpringerLink
Log in

Maxillofacial Surgeries

  • Chapter
  • First Online:
Surgery for Sleep Disordered Breathing

  • 1260 Accesses

Abstract

The genioglossus advancement (GA) is used in combination with other surgical techniques for treatment of severe OSA. The surgical principle consists in mobilizing the whole area of this muscle insertion by incorporating the genial tubercle on the inner cortex via an osteotomy of the chin, and then moving it toward anterior. An isolated efficiency verification according to the principles of evidence-based medicine (EBM) is not available. In a meta-analysis of 80 patients who received a combination of GA and adjunctive procedures (e.g., hyoidsuspension), a success rate of 66% was reported.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Bell RB, Turvey TA. Skeletal advancement for the treatment of obstructive sleep apnea in children. Cleft Palate Craniofac J 2001;38:147-154

    Article  CAS  PubMed  Google Scholar 

  2. Bettega G, Pepin JL, Veale D, Deschaux C, Raphael B, Levy P. Obstructive sleep apnea syndrome. Fifty-one consecutive patients treated by maxillofacial surgery. Am J Respir Crit Care Med 2000;162:641-649

    CAS  PubMed  Google Scholar 

  3. Cedars MG, Linck DL, Chin M, Toth BA. Advancement of the midface using distraction techniques. Plast Reconstr Surg 1999;103:429-441

    Article  CAS  PubMed  Google Scholar 

  4. Cohen SR. Craniofacial distraction with a modular internal distraction system: evolution of design and surgical techniques. Plast Reconstr Surg 1999;103: 1592-1607

    Article  CAS  PubMed  Google Scholar 

  5. Conradt R, Hochban W, Brandenburg U, Heitmann J, Peter JH. Long-term follow-up after surgical treatment of obstructive sleep apnoea by maxillomandibular advancement. Eur Respir J 1997;10:123-128

    Article  CAS  PubMed  Google Scholar 

  6. Dattilo DJ, Drooger SA. Outcome assessment of patients undergoing maxillofacial procedures for the treatment of sleep apnea: comparison of subjective and objective results. J Oral Maxillofac Surg 2004;62:164-168

    Article  PubMed  Google Scholar 

  7. Denny AD, Talisman R, Hanson P, Recinos RF. Mandibular distraction osteogenesis in very young patients to correct airway obstruction. Plast Reconstr Surg 2001;108: 302-311

    Article  CAS  PubMed  Google Scholar 

  8. Elwood ET, Burstein FD, Graham L, Williams JK, Paschal M. Midface distraction to alleviate upper airway obstruction in achondroplastic dwarfs. Cleft Palate Craniofac J 2003;40: 100-103

    Article  PubMed  Google Scholar 

  9. Fibbi A, Ameli F, Brocchetti F, Peirano M, Garaventa G, Presta A, Baricalla F. Combined genioglossus advancement (ACMG): inferior sagittal mandibular osteotomy with genioglossus advancement and stabilization with suture in patients with OSAS. Preliminary clinical results [in Italian]. Acta Otorhinolaryngol Ital 2002; 22:153-157

    CAS  PubMed  Google Scholar 

  10. Foltán R, Hoffmannová J, Pretl M, Donev F, Vlk M. Genioglossus advancement and hyoid myotomy in treating obstructive sleep apnoea syndrome - a follow-up study. J Craniomaxillofac Surg 2007;35:246-251

    PubMed  Google Scholar 

  11. Goh YH, Lim KA. Modified maxillomandibular advancement for the treatment of obstructive sleep apnea: a preliminary report. Laryngoscope 2003;113:1577-1582

    Article  PubMed  Google Scholar 

  12. Harada K, Higashinakagawa M, Omura K. Mandibular lengthening by distraction osteogenesis for treatment of obstructive sleep apnea syndrome: a case report. J Craniomand Prac 2003;21:61-67

    Google Scholar 

  13. Hochban W, Conradt R, Brandenburg U, Heitmann J, Peter JH. Surgical maxillofacial treatment of obstructive sleep apnea. Plast Reconstr Surg 1997;99:619-626

    Article  CAS  PubMed  Google Scholar 

  14. Izadi K, Yellon R, Mandell DL, Smith M, Song SY, Bidic S, Bradley JP. Correction of upper airway obstruction in the newborn with internal mandibular distraction osteogenesis. J Craniofac Surg 2003;14:493-499

    Article  PubMed  Google Scholar 

  15. Johnson NT, Chinn J. Uvulopalatopharyngoplasty and inferior sagittal mandibular osteotomy with genioglossus advancement for treatment of obstructive sleep apnea. Chest 1994;105: 278-283

    Article  CAS  PubMed  Google Scholar 

  16. Karakasis DT, Michaelides CM, Tsara V. Mandibular distraction combined with tongue-base traction for treatment of obstructive sleep apnea syndrome. Plast Reconstr Surg 2001;108:1673-1676

    Article  CAS  PubMed  Google Scholar 

  17. Kerstens HC, Tuinzing DB, van der Kwast WA. Temporomandibular joint symptoms in orthognathic surgery. J Craniomaxillofac Surg 1989;17:215-218

    CAS  PubMed  Google Scholar 

  18. Kuo PC, West RA, Bloomquist DS, McNeil RW. The effect of mandibular osteotomy in three patients with hypersomnia sleep apnea. Oral Surg Oral Med Oral Pathol 1979;48:385-392

    Article  CAS  PubMed  Google Scholar 

  19. Lee NR, Givens CD, Wilson J, Robins RB. Staged surgical treatment of obstrcutive sleep apnea syndrome: a review of 35 patients. J Oral Maxillofac Surg 1999;57: 382-385

    Article  CAS  PubMed  Google Scholar 

  20. Lewis MR, Ducic Y. Genioglossus muscle advancement with the genioglossus bone advancement technique for base of tongue obstruction. J Otolaryngol 2003;32: 168-173

    Article  PubMed  Google Scholar 

  21. Li KK, Guilleminault C, Riley RW, Powell NB. Obstructive sleep apnea and maxillomandibular advancement: an assessment of airway changes using radiographic and nasopharyngoscopic examinations. J Oral Maxillofac Surg 2002;60:526-530

    Article  PubMed  Google Scholar 

  22. Li KK, Powell NB, Riley RW, Guilleminault C. Distraction osteogenesis in adult obstructive sleep apnea surgery: a preliminary report. J Oral Maxillofac Surg 2002; 60:6-10

    Article  PubMed  Google Scholar 

  23. Li KK, Powell NB, Riley RW, Troell RJ, Guilleminault C. Long-term results of maxillomandibular advancement surgery. Sleep Breath 2000;4:137-139

    Article  PubMed  Google Scholar 

  24. Li KK, Riley RW, Powell NB, Guilleminault C. Maxillomandibular advancement for persistent obstructive sleep apnea after phase I surgery in patients without maxillomandibular deficiency. Laryngoscope 2000;110:1684-1688

    Article  CAS  PubMed  Google Scholar 

  25. Li KK, Riley RW, Powell NB, Troell RJ. Obstructive sleep apnea surgery: genioglossus advancement revisited. J Oral Maxillofac Surg 2001;59:1181-1184

    Article  CAS  PubMed  Google Scholar 

  26. Li KK, Riley RW, Powell NB, Zonato A, Troell R, Guilleminault C. Postoperative findings after maxillomandibular advancement for obstructive sleep apnea syndrome. Laryngoscope 2000;110:325-327

    Article  CAS  PubMed  Google Scholar 

  27. Li KK, Troell RJ, Riley RW, Powell NB, Koester U, Guilleminault C. Uvulopalatopharyn­goplasty, maxillomandibular advancement, and the velopharynx. Laryngoscope 2001;111:1075-1078

    Article  CAS  PubMed  Google Scholar 

  28. McCarthy JG, Schreiber J, Karp N, Thorne CH, Grayson BH. Lengthening the human mandible by gradual distraction. Plast Reconstr Surg 1992;89:1-10

    Article  CAS  PubMed  Google Scholar 

  29. Meling TR, Tveten S, Due-Tønnessen BJ, Skjelbred P, Helseth E. Monobloc and midface distraction osteogenesis in pediatric patients with severe syndromal craniosynostosis. Pediatr Neurosurg 2000;33:89-94

    Article  CAS  PubMed  Google Scholar 

  30. Miller FR, Watson D, Boseley M. The role of genial bone advancement trephine system in conjunction with uvulopalatopharyngoplasty in the multilevel management of obstructive sleep apnea. Otolaryngol Head Neck Surg 2004;130:73-79

    Article  PubMed  Google Scholar 

  31. Mintz SM, Ettinger AC, Geist JR, Geist RY. Anatomic relationship of the genial tubercles to the dentition as determined by cross-sectional tomography. J Oral Maxíllofac Surg 1995;53:1324-1326

    Article  CAS  PubMed  Google Scholar 

  32. Mofid MM, Manson PN, Robertson BC, Tufaro AP, Elias JJ, Vander Kolk CA. Craniofacial distraction osteogenesis: a review of 3278 cases. Plast Reconstr Surg 2001;108:1103-1114

    Article  CAS  PubMed  Google Scholar 

  33. Moore MH, Guzman-Stein G, Proudman TW, Abbott AH, Netherway DJ, David DJ. Mandibular lengthening by distraction for airway obstruction in Treacher-Collins syndrome. J Craniofac Surg 1994;5:22-25

    Article  CAS  PubMed  Google Scholar 

  34. Morovic CG, Monasterio L. Distraction osteogenesis for obstructive apneas in patients with congenital craniofacial malformations. Plast Reconstr Surg 2000;105: 2324-2330

    Article  CAS  PubMed  Google Scholar 

  35. Neruntarat C. Genioglossus advancement and hyoid myotomy: short-term and long-term results. J Laryngol Otol 2003;117:482-486

    Article  CAS  PubMed  Google Scholar 

  36. Obwegeser H. Fortschritte und Schwerpunkte der orthopädischen Kiefer -und Gesi­chtschirurgie. In: Fortschr Kiefer Gesichtschir 1976; 21:54-60

    Google Scholar 

  37. Obwegeser H. In: Zur Operationstechnik bei der Progenie und anderer Unterkieferanomalien [in German]. Dtsch Zahn Mund Kieferheilk 1955; 23:1-2

    Google Scholar 

  38. Ortiz-Monasterio F, Drucker M, Molina F, Ysunza A. Distraction osteogenesis in Pierre Robin sequence and related respiratory problems in children. J Craniofac Surg 2002;13: 79-83

    Article  Google Scholar 

  39. Paoli JR, Lauwers F, Lacassagne L, Tiberge M. Treatment of obstructive sleep apnea syndrome by mandibular elongation using osseous distraction followed by a Le Fort I advancement osteotomy: case report. J Oral Maxillofac Surg 2001;59:216-219

    Article  CAS  PubMed  Google Scholar 

  40. Perlyn CA, Schmelzer RE, Sutera SP, Kane AA, Govier D, Marsh JL. Effect of distraction osteogenesis of the mandible on upper airway volume and resistance in children with micrognathia. Plast Reconstr Surg 2002;109:1809-1818

    Article  PubMed  Google Scholar 

  41. Powell NB, Riley RW, Guilleminault C, Nino-Murcia G. Obstructive sleep apnea, continuous positive airway pressure, and surgery. Otolaryngol Head Neck Surg 1988;99:362-369

    CAS  PubMed  Google Scholar 

  42. Prinsell JR. Maxillomandibular advancement (MMA) in a site-specific treatment approach for obstructive sleep apnea: a surgical algorithm. Sleep Breath 2000;4: 147-154

    Article  PubMed  Google Scholar 

  43. Prinsell JR. Maxillomandibular advancement surgery in a site-specific treatment approach for obstructive sleep apnea in 50 consecutive patients. Chest 1999;116: 1519-1529

    Article  CAS  PubMed  Google Scholar 

  44. Ramirez SG, Loube DI. Inferior sagittal osteotomy with hyoid bone suspension for obese patients with sleep apnea. Arch Otolaryngol Head Neck Surg 1996;122: 953-957

    CAS  PubMed  Google Scholar 

  45. Riley RW, Powell NB, Guilleminault C, Nino-Murcia G. Maxillary, mandibular, and hyoid advancement: an alternative to tracheostomy in obstructive sleep apnea syndrome. Otolaryngol Head Neck Surg 1986;94:584-588

    CAS  PubMed  Google Scholar 

  46. Riley RW, Powell NB, Guilleminault C, Ware W. Obstructive sleep anpnea syndrome following surgery for mandibular prognathism. J Oral Maxillofac Surg 1987;45: 450-452

    Article  CAS  PubMed  Google Scholar 

  47. Riley RW, Powell NB, Guilleminault C. Inferior mandibular osteotomy and hyoid myotomy suspension for obstructive sleep apnea: a review of 55 patients. J Oral Maxillofac Surg 1989; 47:159-164

    Article  CAS  PubMed  Google Scholar 

  48. Riley RW, Powell NB, Guilleminault C. Inferior sagittal osteotomy of the mandible with hyoid myotomy-suspension: a new procedure for obstructive sleep apnea. Otolaryngol Head Neck Surg 1986;94:589-593

    CAS  PubMed  Google Scholar 

  49. Riley RW, Powell NB, Guilleminault C. Maxillofacial surgery and nasal CPAP. A comparison of treatment for obstructive sleep apnea syndrome. Chest 1990;98: 1421-1425

    Article  CAS  PubMed  Google Scholar 

  50. Riley RW, Powell NB, Guilleminault C. Obstructive sleep apnea and the hyoid: a revised surgical procedure. Otolaryngol Head Neck Surg 1994;111:717-721

    Article  CAS  PubMed  Google Scholar 

  51. Satoh K, Tsutsumi K, Tosa Y, Mikawa M, Hosaka Y. Le Fort III distraction osteogenesis of midface-retrusion in a case of Hajdu Cheny syndrome. J Craniofac Surg 2002;13:298-302

    Article  PubMed  Google Scholar 

  52. Schierle HP, Schliephake H, Dempf R. Distraktionsosteogenese im Rahmen der Therapie peripherer Atemwegsobstruktionen im Säuglingsalter [in German]. Dtsch Zahnärztl Z 2000; 55:44-48

    Google Scholar 

  53. Sidman JD, Sampson D, Templeton B. Distraction osteogenesis of the mandible for airway obstruction in children. Laryngoscope 2001;111:1137-1146

    Article  CAS  PubMed  Google Scholar 

  54. Uemura T, Hayashi T, Satoh K, Mitsukawa N, Yoshikawa A, Jinnai T, Hosaka Y. A case of improved obstructive sleep apnea by distraction osteogenesis for midface hypoplasia of an infantile Crouzon’s syndrome. J Craniofac Surg 2001;12:73-77

    Article  CAS  PubMed  Google Scholar 

  55. Villani S, Brevi B, Sesenna E. Distraction osteogenesis in a newborn infant with Pierre-Robin sequence [in German]. Mund Kiefer Gesichtschir 2002;6:197-201

    Article  CAS  PubMed  Google Scholar 

  56. Waite PD, Wooten V, Lachner J, Guyette RF. Maxillomandibular advancement surgery in 23 patients with obstructive sleep apnea syndrome. J Oral Maxillofac Surg 1989;47: 1256-1261

    Article  CAS  PubMed  Google Scholar 

  57. Wang X, Wang XX, Liang C, Yi B, Lin Y, Li ZL. Distraction osteogensis in correction of micrognathia accompanying obstructive sleep apnea syndrome. Plast Reconstr Surg 2003;112: 1549-1557

    Article  PubMed  Google Scholar 

  58. White CS, Dilwick MF. Prevalence and variance of temporomandibular dysfunction in orthognathic surgery patients. Int J Adult Orthodon Orthognath Surg 1992;7:7-14

    CAS  PubMed  Google Scholar 

  59. Williams JK, Maull D, Grayson BH, Longaker MT, McCarthy JG. Early decannulation with bilateral mandibular distraction for tracheostomy-dependent patients. Plast Reconstr Surg 1999;103:48-57

    Article  CAS  PubMed  Google Scholar 

  60. Woodson BT, Hanson PR, Melugin MB, Dama AA. Sequential upper airway changes during mandibular distraction for obstructive sleep apnea. Otolaryngol Head Neck Surg 2003;128: 142-144

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology Head and Neck Surgery, Asklepios Clinic Harburg, Eissendorfer Pferdeweg 52, 21075, Hamburg, Germany

    Thomas Verse

  2. Department of Oral and Maxillofacial Plastic Surgery, University of Leipzig, Leipzig, Germany

    Thomas Hierl

Authors
  1. Thomas Verse
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Thomas Hierl
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Verse, T., Hierl, T. (2010). Maxillofacial Surgeries. In: Surgery for Sleep Disordered Breathing. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-77786-1_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-540-77786-1_8

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-77785-4

  • Online ISBN: 978-3-540-77786-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation