Does Aesthetic Osseous Genioplasty Impact Upper Airway Volume?

BACKGROUND: Although maxillomandibular advancement is the treatment of choice for obstructive sleep apnea syndrome (OSAS) in the presence of underlying maxillo-mandibular complex hypoplasia, there is still a gap in the literature regarding the impact of genioplasty upon upper airway volume (UAV).

OBJECTIVES: The aim of this study was to evaluate the impact of isolated osseous genioplasty upon UAV.

METHODS: A retrospective analysis of all patients subjected to isolated osseous genioplasty between July 2015 and July 2022 was conducted. Cone-beam computed tomography was performed pre- and postoperatively to assess the chin and hyoid 3D spatial position and UAV changes after surgery.

RESULTS: A total of 44 patients were included in the study. Regarding surgical movements of the chin, almost all patients received a sagittal movement (n = 42; 39 forwards and 3 backwards), while in 8 patients a vertical movement (5 upwards and 3 downwards) was applied, and in 6 patients the chin was centered. A statistically significant increase in total UAV (p = 0.014) and at the level of the oropharynx (p = 0.004) was observed. Specifically, chin centering, up- and forwards movements enlarged the oropharynx volume (p = 0.006, 0.043 and 0.065, respectively). Chin advancement enlarged the hypopharynx volume (p = 0.032), as well as the upwards movement of the hyoid bone (p < 0.001).

CONCLUSIONS: The study suggests that aesthetic osseous genioplasty impacts upon the UAV: each 3D spatial chin movement impacts differently upon the upper airway by enlarging or narrowing it. However, further studies addressing the apnea-hypopnea index are required to assess its effectiveness in treating OSAS.