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双颌正颌手术如何改变上颌窦和咽腔气道的空间维度?

How does bimaxillary orthognathic surgery change dimensions of maxillary sinuses and pharyngeal airway space?

出版信息

Angle Orthod. 2020 Sep 1;90(5):715-722. doi: 10.2319/120919-782.1.

Abstract

OBJECTIVES

To assess changes in the maxillary sinus (MS) and pharyngeal airway space (PAS) after bimaxillary orthognathic surgery using cone-beam computed tomography (CBCT).

MATERIALS AND METHODS

The CBCT scans of 48 patients were divided into two groups: group 1: maxillary advancement and mandibular setback (n = 24); group 2: maxillomandibular advancement (n = 24). The CBCTs were acquired 1 to 2 months preoperatively and 6 to 8 months postoperatively. A kappa test was used to determine intra- and interexaminer agreement. Area, volume, and linear measurements of MSs and PASs obtained before and after surgery were compared using a mixed model (P < .05).

RESULTS

All variables of the MS showed significant postsurgical reductions in both groups, except the MS length, which showed a significant increase in group 2. Volume and minimum axial area of PAS showed statistically significant postsurgical increases in both groups (P < .05).

CONCLUSIONS

Despite the reduction in the MS and the increase in the PAS, results indicated that the airway was not negatively affected after maxillomandibular advancement and maxillary advancement with mandibular setback.

摘要

目的

使用锥形束 CT(CBCT)评估双颌正颌手术后上颌窦(MS)和咽气道空间(PAS)的变化。

材料与方法

将 48 例患者的 CBCT 扫描分为两组:组 1:上颌骨前突和下颌骨后退(n = 24);组 2:上颌骨和下颌骨前突(n = 24)。在术前 1 至 2 个月和术后 6 至 8 个月采集 CBCT。使用kappa 检验来确定内部和外部检查者之间的一致性。使用混合模型比较手术前后 MS 和 PAS 的面积、体积和线性测量值(P <.05)。

结果

两组患者的 MS 所有变量均显示出明显的术后减少,除了 MS 长度,组 2 明显增加。两组患者的 PAS 体积和最小轴向面积均显示出统计学上的显著增加(P <.05)。

结论

尽管 MS 减少和 PAS 增加,但结果表明上颌骨和下颌骨前突以及上颌骨前突伴下颌骨后退术后气道并未受到负面影响。

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本文引用的文献

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Is Le Fort I Osteotomy Associated With Maxillary Sinusitis?勒福Ⅰ型截骨术与上颌窦炎有关吗?
J Oral Maxillofac Surg. 2016 Feb;74(2):400.e1-400.e12. doi: 10.1016/j.joms.2015.10.006. Epub 2015 Oct 19.

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