TABLE IX.D.5.b.

Evidence on genioglossus advancement for OSA

Study	Year	LOE	Study design	Study groups	Clinical endpoint	Conclusion
Song et al.1804	2016	2a	Systematic review and meta-analysis	1. GA (n = 24) 2. GA-HS (n = 50)	1. AHI 2. LSAT	1. GA: 45.7% AHI reduction, (p < 0.005). No significant LSAT improvement. 2. GA-HS: 55.7% AHI reduction (p < 0.001). LSAT improved from 80% to 88% (p < 0.002)
Kuscu et al.1805	2015	4	Case series	1. GA (n = 17)	AHI, ESS, minimum, and mean O2 saturation variation	53% success rate. Statistically significant differences in AHI, mean SpO2 and ESS score
Chen et al.1795	2014	4	Nonrandomized prospectivecohort study	1. UPPP (n = 27) 2. UPPP + GA (n = 24) 3. UPPP +TBA (n = 26)	Sleep stage, AHI, LSAT, CT90	All significantly improve mean AHI, LSAT, and CT90 scores. No statistical comparison made
Foltan et al.1803	2007	4	Case series	1. GA (n = 31)	ESS, RDI, ODI, duration of the desaturation, basal O2 saturation, and average desaturation variation	74% success rate. Improved ESS, RDI, ODI (p < 0.01)
Richard et al.1799	2006	4	Case–control	1. Multilevel surgery with GA (n = 14) 2. Multilevel surgery without GA (n = 8)	1. AHI 2. ODI 3. ESS	No significant difference outcomes between groups
Riley et al.1797	1993	4	Case series	1. GA-HS (n = 6) 2. GA-HS + UPPP (n = 233) 3. UPPP (n = 10)	Success rate	1. 66% success 2. 60% success 3. 80% success No statistical comparison performed
Riley et al.1792	1986	4	Case series	1. GA-HS (n = 5)	1. AHI, RDI, success	1. 60% success 2. AHI decreased for all patients 3. RDI decreased for all patients by 46%–85%

Abbreviations: AHI, apnea hypopnea index; CT90, percentage of time with saturation below 90%; ESS, Epworth sleepiness scale; GA, genioglossus advancement; HS, hyoid surgery; LSAT, lowest oxygen saturation; ODI, oxygen desaturation index; RDI, respiratory disturbance index; UPPP, uvulopalatopharyngoplasty.