Effective Surgical Treatment for Sleep Apnea

An innovative procedure known as Genial Bone Advancement Trephine (GBAT) treatment is being used to treat obstructive sleep apnea (OSA) syndrome in patients in whom traditional treatments have proven to be ineffective.

Researchers at Thomas Jefferson University (Philadelphia, PA, USA) are performing GBAT as an option for patients when medications or a continuous positive airway pressure (C-PAP) device are insufficient.

The GBAT system allows genioglossus advancement (GGA) of the tongue via a guided trephine system. The procedure involves moving a small portion of the lower jaw known as the genial tubercle, which attaches to the tongue. When this tubercle is moved forward, the tongue is pulled away from the pharynx, increasing the airway space. The procedure is often employed as an adjunct to more conventional surgery and can be very effective at treating OSA.

At the end of the GBAT procedure, the genial tubercle is fastened using a small titanium plate to the outside of the lower jaw. The surgeon works from within the oral cavity, avoiding the need to make any external incisions and avoiding any cosmetic changes. The procedure is usually carried out in conjunction with uvulopalatopharyngoplasty (UPPP) surgery, used to remove excess tissue at the back of the throat (tonsils, uvula, and part of the soft palate). The patient may experience soreness but will not have any change in dental occlusion. The recovery period is usually about two weeks, and three to six months after the procedure, follow-up sleep tests are performed.

"Even immediately after the procedure patients have an easier time breathing,” said Maurits Boon, M.D., a clinical instructor in otolaryngology-head and neck surgery at Thomas Jefferson. "We have also observed that in a select group of patients hypertension drops off.”


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Thomas Jefferson University