title: Cephalometric soft tissue analysis of combined elliptical-window genioglossus advancement and hyoid suspension for obstructive sleep apnea.
abstract: OBJECTIVE
  This study sought to determine the changes in cephalometric facial profile soft tissue measurements after simultaneous elliptical-window genioglossus advancement and hyoid suspension procedures for obstructive sleep apnea.
  
  
  METHODS
  A retrospective analysis of preoperative and postoperative lateral cephalometric soft tissue changes in 23 consecutive patients who had undergone combined elliptical-window genioglossus advancement and hyoid bone suspension for polysomnogram-confirmed obstructive sleep apnea. Six cephalometric soft tissue measurements of the lower face were evaluated: pogonion (Pg'-Pg), menton (Me'-Me), gnathion (G'-G), lower lip (LI-L1i), B point (B-B'), and horizontal distance from subnasale perpendicular to the soft tissue chin at the level of pogonion (SN-Pg'). Statistical analysis was conducted with the paired Student t test (with 95% confidence interval of difference between means) and found significant for P < .05. Post hoc power analysis was conducted.
  
  
  RESULTS
  There were no statistically significant differences among all 6 preoperative and postoperative cephalometric, radiographic soft tissue measurements of the lower facial profile.
  
  
  CONCLUSIONS
  The combined elliptical-window genioglossus advancement and hyoid suspension procedures for obstructive sleep apnea do not significantly change the cephalometric lower facial profile. In patients with an adequate lower facial profile with base-of-tongue obstruction who require surgical management of obstructive sleep apnea without alteration of their lower facial profile, this procedure does not significantly alter the preoperative facial profile.
authors.affiliation: Division of Oral and Maxillofacial Surgery, Allegheny General Hospital, Pittsburgh, PA, USA. jecdna@aol.com
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Cillo
authors.forename: Pankaj
authors.initials: P
authors.lastname: Thakker
authors.forename: David J
authors.initials: DJ
authors.lastname: Dattilo
mesh_terms: D000328:Adult; D002508:Cephalometry; D005145:Face / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D006928:Hyoid Bone / Q000601:surgery*; D008297:Male; D019186:Mandibular Advancement / Q000379:methods*; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D018709:Statistics, Nonparametric; D014059:Tongue / Q000601:surgery*; D016896:Treatment Outcome