Yatabe-Ioshida Marilia Sayako, Campos Letícia Dominguez, Yaedu Renato Yassukata, Trindade-Suedam Ivy Kiemle
1 Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, São Paulo, Brazil.
2 School of Dentistry, University of Michigan, Ann Arbor, MI, USA.
Cleft Palate Craniofac J. 2019 Mar;56(3):314-320. doi: 10.1177/1055665618778622. Epub 2018 May 30.
The purpose of this study was to 3-dimensionally assess the airway characteristics of patients with unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) who underwent orthognathic surgery.
This was a retrospective study.
The study took place at a national referral center for cleft lip and palate rehabilitation.
The sample comprised cone-beam computed tomography (CBCT) scans obtained before and after orthognathic surgery of 15 individuals (30 CBCT scans), divided into 2 groups: UCLP group (n = 9 patients/18 CBCT scans) and BCLP group (n = 6/12 CBCT scans). All patients had a nonsyndromic UCLP or BCLP and a skeletal class III malocclusion at the preoperative period.
Airway volume, pharyngeal minimal cross-sectional area (mCSA), location of mCSA, sella-nasion-A point (SNA) and sella-nasion-B point (SNB) angles, and condylion-A point and condyloid-gnathion linear measurements were assessed in open-source software (ITK-SNAP and SlicerCMF).
Airway dimensions of patients with UCLP and BCLP increase after orthognathic surgery.
After orthognathic surgery, UCLP group showed a significant 20% increase in nasopharynx volume. Although not significant, BCLP group also showed an increase of 18% in the same region. Minimal cross-sectional area remained dimensionally stable after surgery and was all located in the oropharynx region, on both groups. Additionally, a positive correlation was observed between volume and mCSA on both groups.
Overall, individuals with UCLP and BCLP showed an increase in the upper airway after orthognathic surgery and this might explain the breathing and sleep improvements reported by the patients after the surgery.
本研究旨在对接受正颌手术的单侧唇腭裂（UCLP）和双侧唇腭裂（BCLP）患者的气道特征进行三维评估。
这是一项回顾性研究。
该研究在一家全国性唇腭裂康复转诊中心进行。
样本包括15名个体（30次锥形束计算机断层扫描[CBCT]）正颌手术前后获得的CBCT扫描，分为2组：UCLP组（n = 9例患者/18次CBCT扫描）和BCLP组（n = 6例/12次CBCT扫描）。所有患者术前均为非综合征性UCLP或BCLP且为骨性III类错牙合。
在开源软件（ITK-SNAP和SlicerCMF）中评估气道容积、咽部最小横截面积（mCSA）、mCSA位置、蝶鞍-鼻根-A点（SNA）和蝶鞍-鼻根-B点（SNB）角度，以及髁突-A点和髁突-下颌角线性测量值。
UCLP和BCLP患者正颌手术后气道尺寸增加。
正颌手术后，UCLP组鼻咽容积显著增加20%。BCLP组在同一区域虽未达到显著水平，但也增加了18%。两组术后最小横截面积在尺寸上保持稳定，均位于口咽区域。此外，两组的容积与mCSA之间均观察到正相关。
总体而言，UCLP和BCLP患者在正颌手术后上气道有所增加，这可能解释了患者术后报告的呼吸和睡眠改善情况。
