ABSTRACT
Knowledge of the anatomical relationships and size of the geniotubercle and GGM
fiber insertion can aid the surgeon in performing the specific technique of the GA
procedure for the individual patient’s anatomy and precise mandibular osteotomies
for optimal geniotubercle advancement. The main concerns regarding the GA surgi-
cal procedure is to construct the osteotomy to the largest extent possible to increase
the chance of acquiring all of the GGM fibers. Also, optimal surgical technique
limits the size of the fragment to decrease the risk of dental injury or weakening
the bony mandibular integrity without limiting acquisition of the muscle fibers.
Thus, these two concerns limit the size and position of the surgically created genio-
tubercle fragment in each individual patient. When a comprehensive presurgical evaluation identifies the site of airway
obstruction to be the base of the tongue, surgical therapy using the GA provides a
surgical technique to advance the tongue base effectively with a low morbidity.
