Division of Oral Health Sciences, Department of Anatomy and Functional Restorations, Hiroshima University Graduate School of Biomedical and Health Sciences.
Department of Orthodontics, Applied Life Sciences, Hiroshima University Institute of Biomedical and Health Sciences.
J Craniofac Surg. 2023 Oct 1;34(7):1966-1970. doi: 10.1097/SCS.0000000000009479. Epub 2023 Jun 20.
The objective of this study was to determine the tongue-palatal contact changes in patients with skeletal maxillary protrusion after sagittal split ramus osteotomy (SSRO) during swallowing. In this study, 15 patients with maxillary protrusion and 10 normal subjects participated. Before and 3 months after surgery, tongue-palatal contact patterns during swallowing of patients with maxillary protrusion as well as controls were evaluated by electropalatography. The electrode contact number in the alveolar, palatal, and velar parts was examined. The swallowing duration of each phase was also evaluated. In the lateral area of the velar part, incomplete electrode contact was shown at 0.3 seconds in patients with maxillary protrusion. The electrode contact number in the velar part at 0.3 seconds before tongue-palatal complete contact was significantly less in the preoperative patients compared with the controls ( P < 0.05). A small increase in the electrode contact number of the velar part was shown in the postoperative patients at 0.3 and 0.2 seconds before tongue-palatal complete contact ( P < 0.05). The pharyngeal phase duration was significantly larger in the patients with maxillary protrusion before SSRO compared with the controls ( P < 0.05). After SSRO, the pharyngeal phase duration was significantly shortened. It was shown that the tongue-palatal contact pattern during swallowing in patients with maxillary protrusion improved after orthognathic surgery, and the pharyngeal phase duration was also shortened. It is suggested that the changes in the mesiodistal mandibular position by orthognathic surgery can improve tongue posture and movement during swallowing.
本研究旨在探讨上颌前突患者接受矢状劈开下颌骨截骨术（SSRO）后吞咽时舌腭接触的变化。本研究纳入了 15 例上颌前突患者和 10 例正常对照者。在手术前后，采用电腭图评估上颌前突患者及对照组吞咽时的舌腭接触模式。检查了牙槽、腭和软腭部分的电极接触数。还评估了每个吞咽阶段的持续时间。在上部软腭部分的侧区，上颌前突患者在 0.3 秒时显示不完全电极接触。在舌腭完全接触前的 0.3 秒时，术前患者的软腭部分电极接触数明显少于对照组（P<0.05）。术后患者在舌腭完全接触前的 0.3 和 0.2 秒时，软腭部分的电极接触数略有增加（P<0.05）。与对照组相比，SSRO 前上颌前突患者的咽期持续时间明显更长（P<0.05）。SSRO 后，咽期持续时间明显缩短。结果表明，上颌前突患者经正颌手术后吞咽时的舌腭接触模式得到改善，咽期持续时间也缩短。提示正颌手术改变了下颌的近远中位置，从而改善了吞咽时的舌位和运动。
