Genioglossus advancement and hyoid myotomy in treating obstructive sleep apnoea syndrome - A follow-up study.
OBJECTIVE
To assess the success of genioglossus advancement and hyoid myotomy in the obstructive sleep apnoea syndrome (OSAS) therapy by comparing pre- and postoperative respiratory values during sleep. One of the surgical methods of widening the upper airways is to advance the spina mandibulae together with the genioglossus insertion. Thus the whole tongue is advanced, including its base. Hyoid myotomy itself, leads to a very unaesthetic filling up of soft tissues in the submental space. Therefore, the original window method of genioglossus advancement was modified and the so-called tenon and mortise genioplasty according to Delaire was applied.


METHODS
Thirty-one patients underwent genioglossus advancement by the modified genioplasty with hyoid myotomy (8 women and 23 men, mean age 53.2 years; range 35-69 years). Basic polysomnographic parameters were monitored (during sleep) before surgery and 7.3 months (range 3-6 months) postoperatively.


RESULTS
The cumulative success rate was 74%. Subjective assessment of daily sleepiness using the Epworth scale dropped from preoperative 9.6 to 4.7. The average respiratory disturbance index decreased from 20.9 preoperatively to 10.3, the oxygen desaturation index dropped from 15.1 to 8.8, the average preoperative values of baseline oxygen saturation and average desaturation values had been 95.1% and 86.5%, respectively, and had increased postoperatively to 96.0% and 90.3%, respectively. On the average, preoperative desaturation lasted 36.7s whereas it lasted for 31.0 s postoperatively.


CONCLUSIONS
Polysomonographic monitoring proved that changing the upper airways can favourably impact upon respiratory parameters during sleep in OSAS.
Foltán
René
R
Department of Oral and Maxillofacial Surgery, First Faculty of Medicine, Charles University and General Teaching Hospital, Prague, Czech Republic. renefoltan@seznam.cz
Hoffmannová
Jirina
J
Pretl
Martin
M
Donev
Filip
F
Vlk
Marek
M
D000328:Adult; D000368:Aged; D002680:Chin / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009334:Neck Muscles / Q000601:surgery*; D010100:Oxygen / Q000097:blood; D017286:Polysomnography; D011183:Postoperative Complications; D012119:Respiration; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D012894:Sleep Stages / Q000502:physiology; D014059:Tongue / Q000601:surgery*; D016896:Treatment Outcome
D010100:Oxygen