Osseous Genioplasty and Its Impact on Airway Volume-What is the Evidence?

Abstract

Osseous genioplasty (OG) improves facial aesthetics by 3-dimensionally repositioning the chin and associated soft tissues. Although its effects on airway volumes and obstructive sleep apnea (OSA) have been investigated, the available evidence remains limited. The authors of this study performed a systematic review using the databases PubMed/MEDLINE, Web of Science, Google Scholar, Cochrane, and EMBASE through January 2025. Studies assessing the impact of OG on airway volumes and/or OSA metrics were included. Data on chin advancements, hyoid movements, and related outcomes were extracted. Nine studies met the inclusion criteria. Chin advancement ranged from 4 to 12.5 mm (mean: 7.3 mm), and hyoid advancement ranged from 2.17 to 10 mm (mean: 5.6 mm). Six studies assessed airway changes, with most reporting increases in airway size. Among those, 3 studies quantified volumetric changes. On average, total airway volume increased by 8.5%, with initial volumes averaging 17,956.5 mm³ and increasing to 19,467.5 mm³. The average absolute volume increase was 1511 mm³, with the greatest expansion observed in the oropharynx and hypopharynx. Other studies measured linear airway changes, with posterior airway space increasing by a mean of 2.9 mm. One study reported inconsistent results, with some cases demonstrating no significant airway changes postoperatively. These findings suggest a general trend of airway enlargement following intervention. Functional improvements included reductions in apnea-hypopnea index from 27.7 to 12.7 and from 12.4 to 4.4 in 2 studies, along with reported improvements in snoring severity. Genioplasty can enhance airway dimensions and may improve OSA symptoms through forward chin advancement and hyoid elevation. Although outcomes are consistently positive, standardized assessment methods are needed to optimize surgical techniques and evaluate long-term results. Level of Evidence: 4 (Therapeutic).