Department of Oral and Maxillofacial Surgery.
Department of Orthodontics and Dentofacial Orthopedics, Armed Forces Medical College, Pune, India.
J Craniofac Surg. 2021;32(2):569-573. doi: 10.1097/SCS.0000000000007011.
The aim of this study was to quantify upper airway changes following mandibular orthognathic surgery. Treatment records of 50 patients who underwent mandibular orthognathic surgery were divided into 2 groups, that is, Group 1: Cases treated with Mandibular Advancement Surgery and Group 2: Cases treated with Mandibular Setback Surgery with 25 patients in each group. The Lateral Cephalogram and Acoustic Pharyngometry records of both groups were studied at T0 (01 week before surgery) and T1 (01 year postsurgery) for changes in linear airway measurements (Nasopharyngeal Airway Space - NAS, Superior Airway Space - SAS, Posterior Airway Space - PAS and Hypopharyngeal Airway Space (HAS)), hyoid bone position (Mandibular Plane Hyoid distance), mean area and mean volume. The percentage change and change in these parameters per millimeter advancement or setback of mandible at T1 was calculated. A significant increase in linear airway parameters (SAS and PAS); decrease in hyoid distance; and increase in volume and area of upper airway was observed at T1 in Group 1 and reverse was observed in Group 2. The change in airway parameters (SAS, PAS, mean volume and area) was more significant in Group 1 as compared to Group 2. In the current airway centric approach, meticulous assessment and prediction of long-term airway changes post surgery should be an integral part of ortho-surgical diagnosis and treatment planning and suitable modifications in the treatment plan must be made to cater for any potential adverse effects on airway.
本研究旨在定量分析下颌骨正颌手术后上气道的变化。将 50 例行下颌骨正颌手术的患者的治疗记录分为两组,即组 1:接受下颌前伸术治疗的病例和组 2:接受下颌后退术治疗的病例,每组各 25 例。在 T0(手术前 01 周)和 T1(手术后 01 年)时,对两组的侧位头颅片和声学咽腔图记录进行研究,以评估线性气道测量值(鼻咽气道空间-NAS、上气道空间-SAS、后气道空间-PAS 和下咽气道空间(HAS))、舌骨位置(下颌平面舌骨距离)、平均面积和平均体积的变化。计算 T1 时下颌每前伸或后退 1 毫米时这些参数的百分比变化和变化值。在组 1 中,T1 时观察到线性气道参数(SAS 和 PAS)显著增加、舌骨距离减小、以及上气道体积和面积增加;而在组 2 中则观察到相反的情况。与组 2 相比,组 1 中气道参数(SAS、PAS、平均体积和面积)的变化更为显著。在当前以气道为中心的方法中,术后气道长期变化的细致评估和预测应成为正畸诊断和治疗计划的一个组成部分,并且必须对治疗计划进行适当的修改,以应对任何潜在的气道不良影响。