Ventilatory disorders and facial growth: Benefits of early genioplasty

Summary Aim The purpose of this prospective study was to determine whether combined functional genioplasty and orthodontic treatment in patients with vertical mandibular growth can be beneficial not only in achieving an esthetic outcome and orthodontic stability but also for the multi-disciplinary management of oral ventilation. Methods Twenty-five non-obese adolescents (mean age: 14.6 ± 1.4 years) with vertical excess of the lower third requiring genioplasty received surgery following orthodontic treatment. All were predominantly mouth-breathers despite ENT treatment and rehabilitation. The functional before-after impact of genioplasty was examined in a clinical setting using polysomnography. Results Before genioplasty, 52% of the adolescents presented an upper airways resistance syndrome (UARS) with obstructive hypopnea and poor sleep quality. Three to 6 months after genioplasty, the mode of ventilation shifted from oral to nasal ( p p  = 0.08, p  = 0.001, p  = 0.0009, respectively). Respiratory events and sleep pattern became normal. Below, we present two clinical reports involving obstructive sleep apnea syndrome (OSAS). Conclusions Genioplasty performed during puberty promotes spontaneous lip closure and helps restore nasal ventilation. It improves the obstructive disorder and its manifestations during sleep.