Gulhane Military Medical Academy, Dental Sciences Center, Department of Orthodontics, Etlik, Ankara, Turkey.
Int J Oral Maxillofac Surg. 2012 Jul;41(7):820-9. doi: 10.1016/j.ijom.2012.01.003. Epub 2012 Apr 3.
Bimaxillary orthognathic surgery (BOS) is commonly used in the correction of severe Class III deformities (mandibular prognathism with maxillary retrognathism). The postural response of the pharyngeal airway after mandibular setback and maxillary advancement procedures is clinically crucial for maintaining optimum respiration. Patients might suffer from obstructive sleep apnoea, postoperatively. The aim of this study was to determine the effects of BOS on pharyngeal airway space, respiratory function during sleep and pulmonary functions. 21 male patients were analysed using cephalometry, spirometry for pulmonary function tests, and a 1 night sleep study for full polysomnography before and 17±5 months after BOS. The data show that the hyoid bone repositioned to the inferior, the tongue and soft palate displaced to the posterior, narrowed at the oropharynx and hypopharynx and widened at the nasopharynx and velopharynx levels significantly (p<0.05). The alterations indicated decreased airway resistance and better airflow. As a consequence of polysomnography evaluation, the sleep quality and efficiency of the patients improved significantly after BOS. Patients who undergo BOS should be monitored with pulmonary function tests and polysomnography pre- and postoperatively to detect any airway obstruction.
双颌正颌手术（BOS）常用于矫正严重的 III 类畸形（下颌前突伴上颌后缩）。下颌后退和上颌前徙术后咽腔气道的姿势反应对维持最佳呼吸至关重要。患者术后可能会出现阻塞性睡眠呼吸暂停。本研究旨在探讨 BOS 对咽腔气道空间、睡眠呼吸功能和肺功能的影响。21 例男性患者在 BOS 前后 17±5 个月分别进行了头颅测量、肺功能测试的肺活量计检查和 1 晚睡眠研究的全多导睡眠图。数据显示，舌骨位置向下、舌和软腭向后移位、口咽和下咽变窄、鼻咽和咽后间隙变宽，差异有统计学意义（p<0.05）。这些变化表明气道阻力降低，气流更好。多导睡眠图评估结果表明，BOS 后患者的睡眠质量和效率显著提高。接受 BOS 的患者应在术前和术后进行肺功能检查和多导睡眠图监测，以发现任何气道阻塞。
