Cephalometric Evaluation of Pharyngeal Airway Space Changes in the Combined Elliptical Window Genioglossus Advancement, Hyoid Bone Suspension and Uvulopalatopharyngoplasty for Obstructive Sleep Apnea

Thursday, October 10, 2013
Joseph E. Cillo Jr. DMD, MPH, PhD, Oral and Maxillofacial Surgery, Allegheny General Hospial, Pittsburgh, PA
Clay Kim DDS, MD, Oral and Maxillofacial Surgery, Allegheny General Hospital, Pittsburgh, PA
David J. Dattilo DDS, OMFS, Allegheny General Hospital, Pittsburgh, PA
Purpose:

The purpose of this study was the cephalometric evaluation of pharyngeal airway space (PAS) changes in the combined elliptical window genioglossus advancement, hyoid bone suspension and uvulopalatopharyngoplasty in the treatment of obstructive sleep apnea (OSA).

Subjects and Methods:

Subjects who had the combined elliptical genioglossus advancement, hyoid bone suspension and uvulopalatopharyngoplasty for OSA with a minimum of 6 weeks follow-up were included in this study. All pre- and post-operative cephalometric radiographs were taken with the same radiographic machine and the PAS was evaluated with the cephalometric analysis of Arnett-Gunson FAB surgery and Dolphin Imaging 11 (Dolphin Imaging and Management Solutions, Chatsworth, CA) preoperatively and at least 6 weeks postoperatively. Measurements for Nasopharyngeal, Oropharyngeal, Hypopharyngeal, and Deep Pharyngeal airway were obtained. The paired t-test was utilized to determine statistical significance between matched pairs and found significant at the p < .05 level.

Results

There were a total of 13 subjects who met the inclusion criteria.  The average age was 44.7 +/- 5.6 years. There were statistically significant differences in pre- and post-operative mean cephalometric length for oropharyngeal (9.1 +/- 4.4 vs. 17.4 +/- 4.9, p < .05), hypopharyngeal (10.6 +/- 3.6 vs. 14.4 +/- 4.0, p < .05), and deep pharyngeal airway spaces (8.8 +/- 1.6 vs. 16.4 +/- 2.2, p < .05), but not nasopharyngeal airway (9.6 +/- 2.1 vs. 10.4 +/- 3.2, p = .38).

Conclusions:

Subjects who underwent the combined elliptical genioglossus advancement, hyoid bone suspension and uvulopalatopharyngoplasty for OSA had significant increase in anterior posterior dimensions in oropharyngeal, hypopharyngeal, and deep pharyngeal airway spaces.

References:

 

Dattilo DJ, Aynechi M. Modification of the anterior mandibular osteotomy for genioglossus advancement with hyoid suspension for obstructive sleep apnea. J

Oral Maxillofac Surg. 65(9):1876-9, 2007.

Cillo JE Jr, Thakker P, Dattilo DJ. Cephalometric soft tissue analysis of combined elliptical-window genioglossus advancement and hyoid suspension for obstructive sleep apnea. J Oral Maxillofac Surg. 70(3):690-5, 2012.