Genioglossus muscle advancement: A modification of the conventional technique.

Obstructive sleep apnoea syndrome (OSAS) is a pathophysiologic condition associated with fragmented sleep and arousals caused by nocturnal mechanical obstruction of the upper airway. This results in behavioural derangements, such as excessive daytime sleepiness and fatigue, and pathophysiologic derangements that cause morbidities and mortality including hypertension, arrhythmias, myocardial infarction, stroke and sudden death. The genioglossus advancement is a proven technique for the treatment of mild to moderate obstructive sleep apnoea syndrome by relieving airway obstruction at the hypopharyngeal level. In this article, we report a modification of the conventional genioglossus advancement described by Riley and Powell. The modification we describe replaces the bone segment at the mandibular basal bone rather than at the mid area of the symphysis. This means a linear movement that allows a greater advancement and avoids the rotation of the genioglossus muscle. Through this article we will describe the advantages of the surgical technique such as greater effectiveness, stability, more pleasing aesthetic outcome and the reduction of potential complications.

Time used for orthodontic surgical treatment of dentofacial deformities in white patients.

PURPOSE: The aim of the present study was to assess the duration of each treatment phase that a patient with dentofacial disorders and eligible for orthodontic surgery undergoes and to identify those factors that determine the time. We have also included a description of the demographic and skeletal characteristics of the patients treated at our center, the surgery type, and movements performed. PATIENTS AND METHODS: A sample of 148 patients undergoing orthognathic surgery from 2004 to 2007 at Princesa University Hospital, Madrid, was studied. The demographic data of each patient, their facial pattern, skeletal disorders, and surgical movements performed were recorded, as was the duration of orthodontic treatment, both pre- and postoperatively, length of surgery, and length of hospital stay. RESULTS: The length of preoperative orthodontic treatment was 24 months and that of postoperative treatment was 12 months. The average operative time was 4 hours for those interventions in which both dental arches were involved, and the average length of hospital stay was 3 days. No relevant differences were found for the length of orthodontic treatment according to gender, age, or type of skeletal disorder. Differences were observed in the length of hospital stay between those patients who underwent segmentation of the maxilla and those who did not. CONCLUSIONS: The length of the different phases into which an orthodontic surgical treatment is divided can differ within some given limits. However, it does not depend on either the patients' demographic skeletal characteristics or the surgical movements performed.