The role of the Genial Bone Advancement Trephine system in conjunction with uvulopalatopharyngoplasty in the

OBJECTIVES: The successful surgical management of obstructive sleep apnea (OSA) requires surgical procedures that address both retropalatal and re-trolingual airway obstruction. The Genial Bone Ad-vancement 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 sur-gical management of OSA. STUDY DESIGN: Retrospective analysis of 35 consec-utive patients undergoing GGA using the GBAT sys-tem in conjunction with UPPP for the management of OSA during a 3-year period (1999 to 2002). RESULTS: Twenty-four patients had complete preop-erative and postoperative polysomnographic data. A 70 % reduction in the Respiratory Disturbance In-dex (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 con-junction with UPPP can produce significant reduc-tions in RDI and AI while improving the oxygen desaturation and enlarging the posterior airway space. The effective cure rates using the GBAT sys-tem 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. (Otolaryngol Head Neck Surg 2004