Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8588, Japan.
Department of Oral Surgery, Imakiire General Hospital, Kagoshima 890-0051, Japan.
Int J Environ Res Public Health. 2023 Jan 20;20(3):1926. doi: 10.3390/ijerph20031926.
Sagittal split ramus osteotomy (SSRO) is a standard surgical technique for patients with mandibular prognathism. However, the appropriate position of the proximal fragment is not strictly defined, and rigid fixation can induce early postoperative skeletal relapse and temporomandibular (TMJ) disorders. Loose fixation can be expected to seat the proximal bone fragments in a physiologically appropriate position, thereby reducing adverse events. Although long-term skeletal stability has been achieved using SSRO without fixation, the evaluation of preoperative and postoperative eating and swallowing functions remains unclear, and this study aimed to clarify this point. We evaluated mastication time, oral transfer time, and pharyngeal transfer time using videofluorography (VF) preoperatively, two months postoperatively, and six months postoperatively, and along with the position of anatomical landmarks using cephalometric radiographs, modified water swallowing test (MWST), food test (FT), and repetitive saliva swallowing test (RSST) were used to evaluate postoperative swallowing function. Four patients (one male, three females; mean (range) age 26.5 (18-51) years) were included, with a mean setback of 9.5 mm and 6.5 mm on the right and left sides, respectively. Postoperative eating and swallowing functions were good in VF, cephalometric analysis, MWST, FT, and RSST. In the present study, good results for postoperative eating and swallowing functions were obtained in SSRO with loose fixation of the proximal and distal bone segments.
矢状劈开下颌支骨切开术（SSRO）是下颌前突患者的标准手术技术。然而，近端骨块的适当位置并未严格定义，而刚性固定会导致术后早期骨骼复发和颞下颌（TMJ）紊乱。预计松动固定会将近端骨块置于生理上适当的位置，从而减少不良事件。尽管 SSRO 不固定已实现长期骨骼稳定性，但术前和术后进食和吞咽功能的评估仍不清楚，本研究旨在阐明这一点。我们使用录像透视术（VF）在术前、术后两个月和术后六个月评估咀嚼时间、口腔转移时间和咽部转移时间，并使用头影测量放射图评估解剖标志的位置，使用改良水吞咽试验（MWST）、食物试验（FT）和重复唾液吞咽试验（RSST）评估术后吞咽功能。纳入了 4 名患者（1 名男性，3 名女性；平均（范围）年龄 26.5（18-51）岁），右侧和左侧分别平均后退 9.5 毫米和 6.5 毫米。VF、头影测量分析、MWST、FT 和 RSST 均显示术后进食和吞咽功能良好。在本研究中，在近端和远端骨段松动固定的 SSRO 中获得了良好的术后进食和吞咽功能结果。
