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二类和三类错颌畸形患者接受双颌正颌手术后咽腔气道、软腭和舌骨的三维变化:一项回顾性研究。

Three-dimensional alterations in pharyngeal airspace, soft palate, and hyoid bone of class II and class III patients submitted to bimaxillary orthognathic surgery: A retrospective study.

机构信息

Department of Oral Diagnosis, Area of Oral Radiology, Piracicaba Dental School, University of Campinas, Avenida Limeira, 901-13414-018, Piracicaba, São Paulo, Brazil.

Oral and Maxillofacial Surgery, Department of Dentistry, State University of Maringá, Avenida Mandacaru, 1550-87080-000, Maringá, Paraná, Brazil.

出版信息

J Craniomaxillofac Surg. 2019 Jun;47(6):883-894. doi: 10.1016/j.jcms.2019.03.015. Epub 2019 Mar 16.

Abstract

INTRODUCTION

The aim of this retrospective study was to evaluate changes in pharyngeal airway space (PAS), soft palate, and hyoid bone position after bimaxillary orthognathic surgery in skeletal Class II and Class III patients.

METHODS

Patients were divided into Group 1: Class III patients who underwent maxillary osteotomies and mandibular setback surgery (N = 43); and Group 2: Class II patients who underwent maxillomandibular advancement surgery (N = 36). Cone beam computed tomography (CBCT) images were acquired one month before and six to eight months after orthognathic surgery. PAS area, volume and minimum axial area (MAA), soft-palate morphology, and hyoid bone position measurements obtained before and after orthognathic surgery were compared using the Gamma family test (p ≤ 0.10).

RESULTS

In Class II group the maxillomandibular advancement surgery significantly increased the PAS area, volume, and MAA and significantly affected hyoid bone position and soft-palate morphology. In Class III group, maxillary osteotomies and mandibular setback also showed increase in PAS area, however without statistically significant values for most of the evaluated measurements.

CONCLUSION

The results of the present study indicate that PAS and related structures are expected to be improved in Class II patients submitted to bimaxillary surgery, and they are not negatively affected by bimaxillary surgery in Class III patients.

摘要

引言

本回顾性研究旨在评估骨性 II 类和 III 类错颌患者接受双颌正颌手术后咽腔气道(PAS)、软腭和舌骨位置的变化。

方法

患者分为 1 组:行上颌骨截骨和下颌骨后退手术的 III 类患者(N=43);2 组:行上下颌骨前徙手术的 II 类患者(N=36)。在正颌手术前 1 个月和术后 6-8 个月采集锥形束 CT(CBCT)图像。使用伽玛家族检验(p≤0.10)比较正颌手术前后 PAS 面积、体积和最小轴面积(MAA)、软腭形态和舌骨位置的测量值。

结果

在 II 类组中,上颌骨和下颌骨前徙手术显著增加了 PAS 面积、体积和 MAA,显著影响了舌骨位置和软腭形态。在 III 类组中,上颌骨截骨和下颌骨后退也增加了 PAS 面积,但大多数评估指标的数值均无统计学意义。

结论

本研究结果表明,II 类患者接受双颌手术可改善 PAS 和相关结构,而 III 类患者的双颌手术不会对 PAS 及其相关结构产生负面影响。

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