Genioglossus Advancement Surgery

Preparing for Surgery

Prior to surgery, all patients being considered for this surgery will have a CT scan performed to evaluate the lower jawbone and the roots of the lower front teeth. Patients with structural abnormalities in these areas may not be good candidates for this procedure. As in all bone surgeries for OSA, the CT scan will be used to allow virtual surgical planning of your case.

Your surgeon will advise any medications that should be stopped prior to surgery. As with all major surgeries, you should fast for at least 12 hours before your procedure. For your safety, all of your doctor’s pre-surgery instructions must be followed exactly.

How the Procedure Is Performed

Genioglossus advancement surgery is performed in a hospital or outpatient surgery center under general anesthesia.

The surgeon makes a small incision inside the lower lip to expose the central part of the lower jaw. A small rectangular piece or a trapezoid piece of the jaw bone is cut out and pulled forward and secured with a small titanium screw and plate. This repositioning also pulls the attached genioglossus muscle forward. The incision is closed with stitches.

Patients are monitored after surgery but usually discharged in the same day. Antibiotics are prescribed to prevent post-operative infection.

What to Expect After Discharge

Following surgery, patients are restricted to softer diet for a few days before progressing to regular diet. It is very important to stay both hydrated and nourished.

Additional postoperative instructions may include:

• Take pain medications as prescribed. Holding ice chips in the mouth can also help with pain.
• Walk at least 3 times a day starting the day after surgery. Walking helps prevent blood clots from forming in your legs. Patients should avoid strenuous activity for 4 weeks following surgery.
• Do not use mouthwashes, lozenges, or throat sprays as they can irritate the lining of the mouth.
• Sleep with head elevated at 45 degrees for at least three days. This will decrease blood flow to the head and help reduce swelling.

Potential Side Effects & Risks

Your surgeon will schedule a follow-up appointment for approximately one to two weeks after surgery. If any side effects become severe or worrisome, notify your care team right away:

• Bleeding. Typically, there is only minor bleeding or oozing from the incision inside the lower lip. If significant bleeding occurs, it should be reported immediately. You may be advised to go to the emergency room.
• Infection. If the incision inside the lower lip comes apart, it can become infected. To help prevent this, patients should talk as little as possible for the first few days after surgery.
• Tooth Injury. Though rare, it’s possible for the lower front teeth to be injured during the procedure. In rare cases, this may require special dental care or a procedure such as an extraction or root canal.
• Numbness. Because this surgery involves manipulation of the nerves, numbness of the lower teeth, chin and lower lip may occur. This is usually a temporary side effect but, for some patients, some degree of numbness may be permanent.