title: Genial tubercle advancement and genioplasty for obstructive sleep apnea: A systematic review and meta-analysis.
abstract: To perform a systematic review and meta-analysis for studies evaluating genioplasty alone, genial tubercle advancement (GTA) alone, and GTA with hyoid surgery (GTA-HS) to treat obstructive sleep apnea (OSA).
  
  
  
  Ten databases.
  
  
  
  Three authors searched through November 15, 2015.
  
  
  
  1,207 studies were screened; 69 were downloaded; and 13 studies met inclusion criteria. A total of 111 patients were included, with 27 standard genioplasty, 10 modified genioplasty, 24 GTA, and 50 GTA-HS patients. For standard genioplasty, the apnea-hypopnea index (AHI) reduced from a mean ± standard deviation (M ± SD) of 18.8 ± 3.8 (95% confidence interval [CI] 17.6, 20.0) to 10.8 ± 4.0 (95% CI 9.5, 12.1) events/hour (relative reduction 43.8%), P value = 0.0001. Genioplasty improved lowest oxygen saturation (LSAT) from 82.3 ± 7.3% (95% CI 80.0, 84.7) to 86.8 ± 5.2% (95% CI 85.1, 88.5), P value = 0.0032. For modified genioplasty AHI increased by 37.3%. For GTA, the AHI reduced from an M ± SD of 37.6 ± 24.2 (95% CI 27.9, 47.3) to 20.4 ± 15.1 (95% CI 14.4, 26.4) events/hour (relative reduction 45.7%), P value = 0.0049. GTA improved LSAT from 83.1 ± 8.3% (95% CI 79.8, 86.4) to 85.5 ± 6.8% (95% CI 82.8, 88.2), P value = 0.2789. For GTA-HS, the AHI reduced from an M ± SD of 34.5 ± 22.1 (95% CI 28.4, 40.6) to 15.3 ± 17.6 (95% CI 10.4, 20.2) events/hour (relative reduction 55.7%), P value < 0.0001; GTA-HS improved LSAT from 80.1 ± 16.6% (95% CI 75.5, 84.7) to 88.3 ± 6.9% (95% CI 86.4, 90.2), P value = 0.0017.
  
  
  
  Standard genioplasty, GTA and GTA-HS can improve OSA outcomes such as AHI and LSAT. Given the low number of studies, these procedures remain as an area for additional OSA research. Laryngoscope, 127:984-992, 2017.
authors.affiliation: Otolaryngology-Head and Neck Surgery, Division of Sleep Surgery and Medicine, Tripler Army Medical Center, Honolulu, Hawaii, U.S.A.
authors.forename: Sungjin A
authors.initials: SA
authors.lastname: Song
authors.affiliation: Otolaryngology-Head and Neck Surgery, Division of Sleep Surgery and Medicine, Tripler Army Medical Center, Honolulu, Hawaii, U.S.A.
authors.forename: Edward T
authors.initials: ET
authors.lastname: Chang
authors.affiliation: Department of Otorhinolaryngology, Sleep Medicine Centre-Hospital CUF, Porto, Portugal.|Centre for Research in Health Technologies and Information Systems (CINTESIS), University of Porto, Porto, Porto, Portugal.
authors.forename: Victor
authors.initials: V
authors.lastname: Certal
authors.affiliation: Virginia Commonwealth University School of Medicine, Richmond, Virginia, U.S.A.
authors.forename: Michael
authors.initials: M
authors.lastname: Del Do
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Sleep Surgery Division, Stanford University Medical Center, Stanford, California, U.S.A.
authors.forename: Soroush
authors.initials: S
authors.lastname: Zaghi
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Sleep Surgery Division, Stanford University Medical Center, Stanford, California, U.S.A.
authors.forename: Stanley Yung
authors.initials: SY
authors.lastname: Liu
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Sleep Surgery Division, Stanford University Medical Center, Stanford, California, U.S.A.
authors.forename: Robson
authors.initials: R
authors.lastname: Capasso
authors.affiliation: Otolaryngology-Head and Neck Surgery, Division of Sleep Surgery and Medicine, Tripler Army Medical Center, Honolulu, Hawaii, U.S.A.|Department of Psychiatry and Behavioral Sciences, Division of Sleep Medicine, Stanford Hospital and Clinics, Redwood City, California, U.S.A.
authors.forename: Macario
authors.initials: M
authors.lastname: Camacho
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D063172:Genioplasty / Q000379:methods*; D006801:Humans; D008297:Male; D019186:Mandibular Advancement / Q000379:methods; D017286:Polysomnography; D011788:Quality of Life; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000523:psychology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Obstructive sleep apnea; genial tubercle advancement; genioplasty; meta-analysis; systematic review