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Genioglossus

ADVANCEMENT

 

Genioglossus Advancement

 

The tongue is a frequent cause of upper airway blockage in obstructive sleep apnea. It can collapse toward the back of the throat during sleep, therefore contributing to obstruction of the airway. The collapsibility of the tongue can be improved with genioglossus advancement. The genioglossus is the primary muscle of the tongue and is attached to a small bony projection on the interior of the lower jaw. During genioglossus advancement surgery this small projection is moved forward and the tongue attachment is repositioned anteriorly so that it is less likely to collapse posteriorly and block the airway during sleep.

This procedure is performed in a hospital surgery center under general anesthesia.

This procedure takes approximately 30 minutes. Overnight hospitalization is usually recommended afterward and patients usually return to work in 10 to 14 days. While speech and swallowing are not affected, this procedure is typically associated with pain, swelling and occasional minor numbness of the lower front teeth. This procedure is often performed in conjunction with uvulopalatal flap and radiofrequency reduction of the tongue in order to maximize airway improvement.

 

References:

Li KK, Powell NB, Riley RW, Troell RJ, Guilleminault C.  Overview of Phase I Surgery for Obstructive Sleep Apnea Syndrome.  Ear Nose and Throat Journal; 78(11):836-845, 1999.

Guilleminault C, Kim Y, Palombini L, Li K, Powell N.  Upper Airway Resistance Syndrome and its Treatment.  Sleep; 23:S197-S200, 2000. 

Li KK, Powell NB, Riley RW, Guilleminault C.  Maxillomandibular Advancement for Persistent OSA After Phase I Surgery in Patients Without Maxillomandibular Deficiency.  Laryngoscope; 110:1684-1688, 2000.

Li KK, Riley RW, Powell NB, Zonato A.   Fiberoptic Nasopharyngoscopy for Airway Monitoring Following Obstructive Sleep Apnea Surgery.   Journal of Oral and Maxillofacial Surgery; 58:1342-1345, 2000.

Li KK, Riley RW, Powell NB, Troell RJ.  Obstructive Sleep Apnea Surgery: Genioglossus Advancement Revisited.  Journal of Oral and Maxillofacial Surgery. Journal of Oral and Maxillofacial Surgery; 59(10):1181-4, 2001.

Riley RW, Powell NB, Li KK, Guilleminault C.  Surgical Therapy for Obstructive Sleep Apnea Syndrome.  In: Kryger M, editor.  Principles and Practice of Sleep Medicine.  3rd edition.  Philadelphia, PA: WB Saunders, 1999.

Troell RJ, Riley RW, Powell NB, Li KK.  Upper Airway Reconstructive Surgery for Sleep Disordered Breathing.  In: Samuels S, Jaffe R, editors.  Anesthesiologist’s Manual of Surgical Procedures, 2nd Edition.  Philadelphia, PA: Lippincott, Williams & Wilkins Publisher, 1998.

Troell RJ, Riley RW, Powell NB, Li KK.  Long-Term Results of Surgical Management of Sleep Disordered Breathing: Are Our Patients Really Benefiting?  Otolaryngology Clinic of North America; 31(6):1031-1035, 1998.

Troell RJ, Riley RW, Powell NB, Li KK.  Surgical Management of the Hypopharyngeal Airway in Sleep Disordered Breathing.  Otolaryngology Clinic of North America; 31(6):979-1012, 1998.

Li KK, Powell NB.  Therapy – Hypopharyngeal Airway Surgery.  In: Johnson J, Gluckman J and Sanders M, editors.  Management of Obstructive Sleep Apnea. London, England, Martin Duntz Ltd. 2002.

Li KK, Powell NB, Riley RW. Surgical Management of Obstructive Sleep Apnea.  In: Lee-Chiong T, Jr., Carskadon MA, Sateia MH, editors. Sleep Medicine. Philadelphia, PA, Hanley & Belfus Inc.  2001. 

Li KK, Powell N, Riley R.  Postoperative Management of the Obstructive Sleep Apnea Patients.  Oral and Maxillofacial Surgery Clinics of North America; 14:401-404, 2002. 

Li KK, Riley R, Powell N.  Complications of Obstructive Sleep Apnea Surgery. Oral and Maxillofacial Surgery Clinics of North America;15:297-304, 2003.

Li KK.  Surgical Management of Obstructive Sleep Apnea.  Clinics in Chest Medicine; 24:365-370, 2003.

Li KK.  Obstructive Sleep Apnea – Surgical Treatment.  In: Carney PR, Berry RB, Geyer JD, editors.  Clinical Sleep Disorders. Philadelphia, PA, Lippincott, Williams & Wilkins, 2004.

Li KK.  Surgical Therapy for Obstructive Sleep Apnea Syndrome. Seminars in Respiratory and Critical Care Medicine; 26:80-88, 2005.

Li KK.  Surgical Therapy for Adult Obstructive Sleep Apnea.  Sleep Med Rev; 9(3): 201-209, 2005.