Güven Orhan, Saraçoğlu Umut
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Ankara, Ankara, Turkey.
J Craniofac Surg. 2005 Jan;16(1):23-30. doi: 10.1097/00001665-200501000-00007.
Although mandibular setback might lead to possible pharyngeal narrowing, the development of obstructive sleep-related breathing disorders may occur because of multiple factors. In this study, the changes in the pharyngeal airway space (PAS) and the hyoid bone position have been evaluated before and after surgery in patients who underwent body ostectomy (BO) and sagittal split ramus osteotomy (SSRO). In addition, the effects of the BO on PAS and on hyoid bone position have been compared with the effects of the SSRO.
Thirty patients with mandibular prognathism underwent mandibular setback osteotomy. The patients were divided into two groups: BO group, 15 patients (5 men, 10 women) who underwent BO; and SSRO group, 15 patients (11 men, 4 women) who underwent SSRO. Changes in PAS and hyoid bone position were analyzed throughout the preoperative and early and long-term postoperative periods via lateral cephalometric radiographs.
A decrease has been observed in the PAS area and the anteroposterior dimension of the PAS detected in all patients in the long-term period. Hyoid bone revealed backward and downward movement during the early postoperative period; however, it showed a tendency to return to its original anatomic position during the long-term postoperative period. None of the patients had disturbances in respiration.
After BO and SSRO, a decrease in PAS area was observed, and this decrease also continued in the long-term period. Our results revealed a decrease in PAS area after BO, but the decrease was less than that in cases having SSRO.
尽管下颌后缩可能导致咽腔狭窄,但阻塞性睡眠呼吸障碍的发生可能是多种因素所致。在本研究中,对接受体部截骨术(BO)和矢状劈开下颌支截骨术(SSRO)的患者,评估了手术前后咽气道间隙(PAS)和舌骨位置的变化。此外,还比较了BO与SSRO对PAS和舌骨位置的影响。
30例下颌前突患者接受下颌后缩截骨术。患者分为两组:BO组,15例患者(5例男性,10例女性)接受BO;SSRO组,15例患者(11例男性,4例女性)接受SSRO。通过头颅侧位X线片分析术前、术后早期和长期PAS及舌骨位置的变化。
长期观察发现,所有患者的PAS面积及PAS的前后径均减小。术后早期舌骨向后下方移动;然而,在术后长期,舌骨有恢复至其原始解剖位置的趋势。所有患者均无呼吸障碍。
BO和SSRO术后,PAS面积减小,且长期持续存在。我们的结果显示,BO术后PAS面积减小,但减小程度小于SSRO患者。