Genial swing orthomorphic osteotomy: a novel technique for retrogenia-associated obstructive sleep apnoea

Retrogenia, despite its anatomical significance, remains under-recognized as a contributing factor in obstructive sleep apnoea (OSA). While retrognathia and micrognathia are well-documented, retrogenia as an isolated morphological variant has received limited attention in the context of OSA. This technical note introduces the genial swing orthomorphic osteotomy (GSOO), a novel orthomorphic surgical technique specifically designed to address dysmorphology associated with retrogenia. The procedure repositions the genial segment to enhance posterior airway space, while also achieving favourable facial aesthetics. The surgical technique is described in detail, highlighting key anatomical considerations, planning steps, and intra-operative execution. Preliminary application in two patients with OSA secondary to retrogenia demonstrated improvements in airway dimensions, apnoea-hypopnoea index (AHI), and facial profile as well as significant improvement across all eight symptoms domains of the OSA QoL (Quality of Life) questionnaire. The technique presents as a promising intervention for selected patients with OSA linked to retrogenia, warranting further clinical evaluation.