title: Predicting Surgical Response Using Tensiometry in OSA Patients after Genioglossus Advancement with Uvulopalatopharyngoplasty.
abstract: OBJECTIVE
  To evaluate the role of tension on the genioglossus muscle in the performance of genioglossus advancement on sleep-disordered breathing in patients undergoing multilevel obstructive sleep apnea (OSA) surgery.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Academic practice.
  
  
  METHODS
  Twenty-three subjects underwent genioglossus advancement with uvulopalatopharyngoplasty for OSA. Subjects underwent pre- and postoperative polysomnography, cephalometry, and subjective assessment questionnaires. Eighteen subjects completed the study. The tension force of the mandible and the bicortical width of the genial tubercle were measured and surgical response determined.
  
  
  RESULTS
  Improvement in apnea-hypopnea index (AHI) was seen in 15 of 18 subjects (83.3%). Eleven subjects were classified as responders and 7 as nonresponders (61.1% success), with responders exhibiting a statistically significant reduction in mean delta AHI as compared with nonresponders: 28.3 ± 26.2 versus 2.0 ± 22.0 events per hour (95% confidence interval, 1.8-50.8; P = .037). The Epworth Sleepiness Scale improved from 13.2 ± 4.5 to 7.6 ± 3.4 (P = .002). There was no significant difference in body mass index, neck circumference, overall tension, or mandibular width between responders and nonresponders. However, there was a significant difference in the tension:width ratio between responders (53.9 ± 6.38 g/mm) and nonresponders (65.4 ± 11.2 g/mm; 95% confidence interval, 0.92-22.1; P = .036).
  
  
  CONCLUSIONS
  This article describes a novel approach to determine the force applied to the genioglossus during advancement and its correlation to postoperative outcomes. The tension:width ratio may be an indicator for postoperative success and delta AHI improvement in OSA patients.
authors.affiliation: San Antonio Military Medical Center, Fort Sam Houston, Texas, USA Uniformed Services University, Bethesda, Maryland, USA University of Texas Health Sciences Center, San Antonio, Texas, USA Texas Facial Plastic Surgery and ENT, San Antonio, Texas, USA admin@drjosebarrera.com.
authors.forename: José E
authors.initials: JE
authors.lastname: Barrera
authors.affiliation: San Antonio Military Medical Center, Fort Sam Houston, Texas, USA.
authors.forename: Gregory R
authors.initials: GR
authors.lastname: Dion
mesh_terms: D000328:Adult; D002508:Cephalometry; D005152:Facial Muscles / Q000601:surgery*; D005260:Female; D006801:Humans; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods; D010160:Palate, Soft / Q000601:surgery*; D010614:Pharynx / Q000601:surgery*; D017286:Polysomnography; D011237:Predictive Value of Tests; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014609:Uvula / Q000601:surgery*
keywords: AHI; apnea-hypopnea index; force tension; genioglossal advancement; geniotubercle advancement; obstructive sleep apnea; sleep surgery success; surgical response; tensiometry; uvulopalatopharyngoplasty