Sleep Breath 2001; 05(4): 173-180
DOI: 10.1055/s-2001-18806
CASE REPORT

Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Mortised Genioplasty in the Treatment of Obstructive Sleep Apnea: An Historical Perspective and Modification of Design

Barry Hendler1,2,3 , Keith Silverstein2,3,8 , Helen Giannakopoulos1,2,3 , Bernard J. Costello4,5,6,7
  • 1Department of Oral and Maxillofacial Surgery at The University of Pennsylvania Medical Center
  • 2Children's Hospital of Philadelphia
  • 3The University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania
  • 4Department of Oral and Maxillofacial Surgery, School of Dental Medicine, University of Pittsburgh
  • 5Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
  • 6Clinical Faculty, Otorhinolaryngology/Head and Neck Surgery, Georgetown University Medical Center, Washington, D.C.
  • 7Oral and Maxillofacial Surgery, Georgetown University Medical Center, Washington, D.C
  • 8private practice, Paoli, Pennsylvania
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Publikationsdatum:
05. Dezember 2001 (online)

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ABSTRACT

We describe a modified technique for mortised genioglossus advancement for treating obstructive sleep apnea and review the history of osteotomies in this region. This new osteotomy technique allows for greater soft tissue advancement of the hypopharyngeal region. Anatomical data from a previous study were used to evaluate the dimensions of the anterior mandible and design an osteotomy that overcomes shortcomings of previous designs. These anatomic measurements enabled us to estimate the size and formulate a design utilized in the anterior mandible for the treatment of obstructive sleep apnea. We believe this design offers the greatest amount of muscular advancement by including genioglossus, geniohyoid, digastric, and mylohyoid. This advancement results in increasing the posterior airway space by volumetric expansion. Custom-designed fixation was utilized to increase stability laterally and decrease the risk of mandibular fracture. The design should be a significant aid in reconstruction of the hypopharyngeal airway in patients with obstructive sleep apnea.

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