The role of the Genial Bone Advancement Trephine system in conjunction with uvulopalatopharyngoplasty in the multilevel management of obstructive sleep apnea

Frank R Miller, Daniel Watson, Mark Boseley

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

OBJECTIVES: The successful surgical management of obstructive sleep apnea (OSA) requires surgical procedures that address both retropalatal and retrolingual airway obstruction. The Genial Bone Advancement Trephine (GBAT) system is a new, 1-step system that allows for isolation and advancement of the genioglossus muscle via a guided trephine system. The purpose of this project was to describe our experience using the GBAT system to perform genioglossus advancement (GGA) in conjunction with uvulopalatopharyngoplasty (UPPP) in the surgical management of OSA. STUDY DESIGN: Retrospective analysis of 35 consecutive patients undergoing GGA using the GBAT system in conjunction with UPPP for the management of OSA during a 3-year period (1999 to 2002). RESULTS: Twenty-four patients had complete preoperative and postoperative polysomnographic data. A 70% reduction in the Respiratory Disturbance Index (RDI) and Apnea Index (AI) in the preoperative versus postoperative PSG (RDI, 52.9 ± 17.1 versus 15.9 ± 7.5; AI, 20.1 ± 6.7 versus 6.1 ± 4.5; P ≤ 0.0001). The lowest oxygen desaturation increased from 80% to 88% (P = 0.0002), and the posterior airway increased from 7.9 to 12.6 mm (P < 0.0001). With a surgical cure defined as a greater than 50% reduction in the RDI and a final postoperative RDI of less than 20 events per hour, the true surgical cure rate was 67% (16 of 24 patients). CONCLUSIONS: The GBAT system performed in conjunction with UPPP can produce significant reductions in RDI and AI while improving the oxygen desaturation and enlarging the posterior airway space. The effective cure rates using the GBAT system are in agreement with previous reports in the literature using various GGA techniques. The GBAT may have some advantages in terms of simplicity and safety.

Original languageEnglish (US)
Pages (from-to)73-79
Number of pages7
JournalOtolaryngology - Head and Neck Surgery
Volume130
Issue number1
DOIs
StatePublished - Jan 2004

Fingerprint

Obstructive Sleep Apnea
Bone and Bones
Apnea
Oxygen
Airway Obstruction
Safety
Muscles

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

@article{3eaf16553046498398b419df5726c7e5,
title = "The role of the Genial Bone Advancement Trephine system in conjunction with uvulopalatopharyngoplasty in the multilevel management of obstructive sleep apnea",
abstract = "OBJECTIVES: The successful surgical management of obstructive sleep apnea (OSA) requires surgical procedures that address both retropalatal and retrolingual airway obstruction. The Genial Bone Advancement Trephine (GBAT) system is a new, 1-step system that allows for isolation and advancement of the genioglossus muscle via a guided trephine system. The purpose of this project was to describe our experience using the GBAT system to perform genioglossus advancement (GGA) in conjunction with uvulopalatopharyngoplasty (UPPP) in the surgical management of OSA. STUDY DESIGN: Retrospective analysis of 35 consecutive patients undergoing GGA using the GBAT system in conjunction with UPPP for the management of OSA during a 3-year period (1999 to 2002). RESULTS: Twenty-four patients had complete preoperative and postoperative polysomnographic data. A 70{\%} reduction in the Respiratory Disturbance Index (RDI) and Apnea Index (AI) in the preoperative versus postoperative PSG (RDI, 52.9 ± 17.1 versus 15.9 ± 7.5; AI, 20.1 ± 6.7 versus 6.1 ± 4.5; P ≤ 0.0001). The lowest oxygen desaturation increased from 80{\%} to 88{\%} (P = 0.0002), and the posterior airway increased from 7.9 to 12.6 mm (P < 0.0001). With a surgical cure defined as a greater than 50{\%} reduction in the RDI and a final postoperative RDI of less than 20 events per hour, the true surgical cure rate was 67{\%} (16 of 24 patients). CONCLUSIONS: The GBAT system performed in conjunction with UPPP can produce significant reductions in RDI and AI while improving the oxygen desaturation and enlarging the posterior airway space. The effective cure rates using the GBAT system are in agreement with previous reports in the literature using various GGA techniques. The GBAT may have some advantages in terms of simplicity and safety.",
author = "Miller, {Frank R} and Daniel Watson and Mark Boseley",
year = "2004",
month = "1",
doi = "10.1016/j.otohns.2003.09.015",
language = "English (US)",
volume = "130",
pages = "73--79",
journal = "Otolaryngology - Head and Neck Surgery (United States)",
issn = "0194-5998",
publisher = "Mosby Inc.",
number = "1",

}

TY - JOUR

T1 - The role of the Genial Bone Advancement Trephine system in conjunction with uvulopalatopharyngoplasty in the multilevel management of obstructive sleep apnea

AU - Miller, Frank R

AU - Watson, Daniel

AU - Boseley, Mark

PY - 2004/1

Y1 - 2004/1

N2 - OBJECTIVES: The successful surgical management of obstructive sleep apnea (OSA) requires surgical procedures that address both retropalatal and retrolingual airway obstruction. The Genial Bone Advancement Trephine (GBAT) system is a new, 1-step system that allows for isolation and advancement of the genioglossus muscle via a guided trephine system. The purpose of this project was to describe our experience using the GBAT system to perform genioglossus advancement (GGA) in conjunction with uvulopalatopharyngoplasty (UPPP) in the surgical management of OSA. STUDY DESIGN: Retrospective analysis of 35 consecutive patients undergoing GGA using the GBAT system in conjunction with UPPP for the management of OSA during a 3-year period (1999 to 2002). RESULTS: Twenty-four patients had complete preoperative and postoperative polysomnographic data. A 70% reduction in the Respiratory Disturbance Index (RDI) and Apnea Index (AI) in the preoperative versus postoperative PSG (RDI, 52.9 ± 17.1 versus 15.9 ± 7.5; AI, 20.1 ± 6.7 versus 6.1 ± 4.5; P ≤ 0.0001). The lowest oxygen desaturation increased from 80% to 88% (P = 0.0002), and the posterior airway increased from 7.9 to 12.6 mm (P < 0.0001). With a surgical cure defined as a greater than 50% reduction in the RDI and a final postoperative RDI of less than 20 events per hour, the true surgical cure rate was 67% (16 of 24 patients). CONCLUSIONS: The GBAT system performed in conjunction with UPPP can produce significant reductions in RDI and AI while improving the oxygen desaturation and enlarging the posterior airway space. The effective cure rates using the GBAT system are in agreement with previous reports in the literature using various GGA techniques. The GBAT may have some advantages in terms of simplicity and safety.

AB - OBJECTIVES: The successful surgical management of obstructive sleep apnea (OSA) requires surgical procedures that address both retropalatal and retrolingual airway obstruction. The Genial Bone Advancement Trephine (GBAT) system is a new, 1-step system that allows for isolation and advancement of the genioglossus muscle via a guided trephine system. The purpose of this project was to describe our experience using the GBAT system to perform genioglossus advancement (GGA) in conjunction with uvulopalatopharyngoplasty (UPPP) in the surgical management of OSA. STUDY DESIGN: Retrospective analysis of 35 consecutive patients undergoing GGA using the GBAT system in conjunction with UPPP for the management of OSA during a 3-year period (1999 to 2002). RESULTS: Twenty-four patients had complete preoperative and postoperative polysomnographic data. A 70% reduction in the Respiratory Disturbance Index (RDI) and Apnea Index (AI) in the preoperative versus postoperative PSG (RDI, 52.9 ± 17.1 versus 15.9 ± 7.5; AI, 20.1 ± 6.7 versus 6.1 ± 4.5; P ≤ 0.0001). The lowest oxygen desaturation increased from 80% to 88% (P = 0.0002), and the posterior airway increased from 7.9 to 12.6 mm (P < 0.0001). With a surgical cure defined as a greater than 50% reduction in the RDI and a final postoperative RDI of less than 20 events per hour, the true surgical cure rate was 67% (16 of 24 patients). CONCLUSIONS: The GBAT system performed in conjunction with UPPP can produce significant reductions in RDI and AI while improving the oxygen desaturation and enlarging the posterior airway space. The effective cure rates using the GBAT system are in agreement with previous reports in the literature using various GGA techniques. The GBAT may have some advantages in terms of simplicity and safety.

UR - http://www.scopus.com/inward/record.url?scp=1642495613&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=1642495613&partnerID=8YFLogxK

U2 - 10.1016/j.otohns.2003.09.015

DO - 10.1016/j.otohns.2003.09.015

M3 - Article

C2 - 14726913

AN - SCOPUS:1642495613

VL - 130

SP - 73

EP - 79

JO - Otolaryngology - Head and Neck Surgery (United States)

JF - Otolaryngology - Head and Neck Surgery (United States)

SN - 0194-5998

IS - 1

ER -