In obstructive sleep apnea, tongue is the main cause for upper airway blockage.
During sleep, the tongue collapses toward the back of the throat which contributes to airway blockage.
Genioglossus advancement improves the condition of collapsibility of the tongue. Genioglossus is attached to a small bony projection on the interior of the lower jaw.
Genioglossus advancement procedure captures this area of attachment and moves it forward. The airway is widened during sleep.
Genioglossus advancement procedure:
The genioglossus advancement procedure takes 30 minutes approximately. Overnight hospitalization is required. Patient can return to their work in 10 to 14 days after the surgery.
The genioglossus advancement procedure is done through a cut inside the lower lip. To expose the central part of the lower jaw, the chin muscles and other soft tissues are cleared away.
To capture the area of the attachment of the genioglossus muscle, small rectangular cuts are made in the lower jaw below the lower front teeth.
The bone rectangle is moved forward and turned slightly. To hold the bone fragment in place, a small titanium screw is used. The soft tissues and chin muscles are replaced and incision is closed with stitches.
Genioglossus advancement procedure risks:
- Infection occurs after the genioglossus advancement procedure only if the incision inside the lower lip comes apart. To prevent the infection, the patient should avoid talking for three days unless it is necessary after the surgery. Infection can be reduced by receiving necessary antibiotics.
- If bleeding occurs underneath the tongue, it can push the tongue backwards. There will be only minor bleeding from the incision inside the lower lip. Avoid aspirins before and after surgery to avoid bleeding. Controlling blood pressure also reduces the risk of bleeding.
- Your chin can change in appearance due to the moving of rectangular piece forward. To make the changes in appearance less, the jaw bone has three layers and the outer two layers are removed from this piece of bone.
- The jaw bone is weakened by the piece of bone that is cut and moved forward. Patient should be careful in avoiding significant trauma to the lower jaw bone because there is an increased risk of fracture.
- During the genioglossus advancement procedure, the nerves travel through the lower jaw bone up to the lower front four teeth. The nerves are cut during the procedure and therefore tooth numbness occurs. In some patients, permanent numbness in the four teeth can occur.
- After the genioglossus advancement procedure, swelling occurs and can have difficulty in swallowing. But the problem is temporary. As the nerves that are responsible for tongue movement are not present in the area the surgery is performed, it will not be affected by the procedure.
After the surgery:
After the genioglossus advancement procedure, you should take the prescribed medication for pain control and do not let the pain increase until it becomes intolerable.
Immediately after the surgery, you may have trouble in swallowing. You should be careful in eating and drinking. You have to eat soft foods and avoid hot foods and hot drinks.
Healing depends on the cut and muscle recovering without coming apart. When you talk, the chin muscle moves to great extent and it is helpful to allow this muscle to rest during the initial healing process by avoiding talking for three days following the surgery.