Surgical Technique
The Repose® Bone Screw Inserter is placed through a small submental incision and manipulated towards the predetermined site of screw insertion. The inserter handle is positioned perpendicular to the angle of the mandible (Figure 1). The safety is released, the power button is pressed, and the screw is inserted. The permanent, looped suture is cut to form two tails of equal length.

A temporary loop suture is preloaded into the Repose Suture Passer. The Suture Passer is passed from the insertion incision to the posterior base of the tongue, exiting 1cm lateral to the midline at the level of the lingual tonsils, just at or behind the circumvallate papillae (Figure 2). The suture is released from the passer and the passer is removed. There is now a temporary looped suture protruding from the base of the tongue.

Using the Suture Passer, one of the screw's polypropylene suture ends is loaded and passed from the same insertion incision to the posterior base of the tongue on the contralateral side (Figure 3).

After securing the polypropylene suture to a Mayo needle, a superficial submucosal pass is made from its exit point to the contralateral side, and threaded through the temporary looped suture (Figure 4).

The looped suture is then pulled anteriorly through the inserter incision, drawing the polypropylene suture toward the insertion site of the screw. A triangular suture pass through the tongue has now been achieved (Figure 5). The two polypropylene suture ends are tied together, bringing the tongue base forward 3-7 mm. The knot is then buried and defect closed with an absorbable suture.