title: Geniotubercle advancement with a uvulopalatal flap and its effect on swallow function in obstructive sleep apnea.
abstract: OBJECTIVE
  Evaluate swallowing characteristics before and after geniotubercle advancement (GTA) with a uvulopalatal flap (UPF).
  
  
  METHODS
  Prospective case control series in an academic military practice.
  
  
  METHODS
  Fourteen patients with apnea-hypopnea index (AHI) >10 scheduled for GTA were enrolled consecutively, eight of whom completed all aspects of the study for evaluation. Video fluoroscopic swallow study was performed preoperatively and 4 months postoperatively. National Institute of Health freeware ImageJ64 software was used to measure hyolaryngeal elevation and displacement. Video recordings assessed vallecular pooling, aspiration, and bolus movement. Studies were reviewed by a speech pathologist and an otolaryngologist.
  
  
  RESULTS
  Preoperatively, the mean AHI was 48.3 ± 48.45 events per hour, with a median of 48.5 (range, 12.4-76). Postoperatively the mean AHI was 11.6 ± 10.7 events per hour, with a median of 10.75 (range, 3.8-29) (P = .003). There was no reported pre- or postoperative dysphagia or aspiration. No radiographic evidence of silent aspiration was seen. Hyolaryngeal movements were measured as a percentage of C2-C4 reference distance. The superior elevations were pre- and postoperatively 40% and 37% (P = .85), anterior displacement changes 18.9% and 18.8% (P = .23), and total motion 49% and 42% (P = .26), respectively.
  
  
  CONCLUSIONS
  GTA with UPF surgery did not significantly affect the hyolaryngeal function of patients.
authors.affiliation: Department of Otolaryngology , San Antonio Military Medical Center, San Antonio, Texas, U.S.A.
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Rohrer
authors.forename: Robert
authors.initials: R
authors.lastname: Eller
authors.forename: Phyllis G
authors.initials: PG
authors.lastname: Santillan
authors.forename: Jose E
authors.initials: JE
authors.lastname: Barrera
mesh_terms: D000328:Adult; D000368:Aged; D003679:Deglutition / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D017286:Polysomnography; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology / Q000601:surgery*; D013524:Surgical Flaps; D016896:Treatment Outcome; D014609:Uvula / Q000601:surgery*
keywords: Obstructive sleep apnea; geniotubercle advancement; sleep surgery; swallow function; uvulopalatopharyngoplasty; video fluoroscopic swallow study