Sahoo N K, Agarwal Shiv Shankar, Datana Sanjeev, Bhandari S K
Department of Oral and Maxillofacial Surgery, Armed Forces Medical College, Pune, India.
Department of Orthodontics and Dentofacial Orthopedics, Armed Forces Medical College, Pune, India.
J Maxillofac Oral Surg. 2020 Dec;19(4):624-629. doi: 10.1007/s12663-020-01375-2. Epub 2020 Apr 25.
The spatial position and dimensions of oral and pharyngeal soft tissues change post-mandibular advancement (MA) surgery which involves changes in position of soft palate, tongue and associated musculature. There is no study which simultaneously evaluates changes in tongue length and height post-MA surgery and correlates these changes with changes in upper airway dimensions and the amount of MA.
Treatment records of 18 patients that underwent MA with bilateral sagittal split ramus osteotomy were evaluated at T1 (01 week before surgery) and T2 (06 months post-surgery). Linear airway and tongue measurements were done on lateral cephalogram. Mean volume and mean pharyngeal area values were recorded from the acoustic pharyngometry (AP) records of patients.
A statistically significant increase in tongue length ( value < 0.001) and nonsignificant change in tongue height were observed at T2 ( value > 0.05). A statistically significant increase in airway parameters recorded on both lateral cephalogram and AP was observed at T2 ( value < 0.001). Correlation analysis did not show a statistically significant correlation of change in tongue length and tongue height at T2 with the amount of MA, change in airway parameters on lateral cephalogram and AP ( value > 0.05).
Mandibular advancement surgery is a viable option for improvement in pharyngeal airway in skeletal Class II patients with retrognathic mandible. Changes in tongue length observed in our study may correspond to the stretch of protruders of tongue, especially genioglossus, and may point toward possible relapse on a long-term follow-up.
下颌前徙(MA)手术会改变口腔和咽部软组织的空间位置及尺寸,这涉及软腭、舌头及相关肌肉组织位置的变化。目前尚无研究同时评估MA手术后舌头长度和高度的变化,并将这些变化与上气道尺寸的变化及MA量相关联。
对18例行双侧矢状劈开下颌支截骨术进行MA手术的患者的治疗记录在T1(术前1周)和T2(术后6个月)进行评估。在头颅侧位片上进行气道和舌头的线性测量。从患者的声学咽测量(AP)记录中记录平均容积和平均咽部面积值。
在T2时观察到舌头长度有统计学意义的增加( 值<0.001),而舌头高度无显著变化( 值>0.05)。在T2时,在头颅侧位片和AP上记录的气道参数均有统计学意义的增加( 值<0.001)。相关性分析未显示T2时舌头长度和高度的变化与MA量、头颅侧位片和AP上气道参数的变化有统计学意义的相关性( 值>0.05)。
下颌前徙手术是改善下颌后缩的骨骼II类患者咽部气道的可行选择。我们研究中观察到的舌头长度变化可能对应于舌头突出肌,尤其是颏舌肌的伸展,并且可能表明在长期随访中可能出现复发。