Consultant Dentomaxillofacial Radiology, Department of Imaging and Function, Skåne University Hospital, Lund, Sweden.
Consultant Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Skåne University Hospital, Lund, Sweden; Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
J Oral Maxillofac Surg. 2024 Jan;82(1):36-46. doi: 10.1016/j.joms.2023.09.017. Epub 2023 Sep 27.
Orthognathic surgery addresses facial aesthetics and function in patients with dentofacial deformities. It is associated with changes in upper airway volume (UAV). If changes in UAV are perceived by asymptomatic patients is unclear.
The purpose was to measure associations between changes in UAV and patient-reported benefits using patient-reported outcome measures.
A sample presenting dentofacial deformities without reported breathing problems undergoing orthognathic surgery was retrospectively studied. Patients aged 18-30 years with 12-month follow-up were included. Patients with systemic disease, drug abuse, mental health disorder, or temporomandibular joint dysfunction were excluded.
The predictor variable was changes in UAV measured in 3-dimensional computed tomography. Subjects were grouped into increased or decreased UAV.
The primary outcome variable was changes in health-related quality of life measured with Oral Health Impact Profile 49 (OHIP-49).
Weight, height, age, sex, and sub-scaled OHIP-49 were registered. Cephalometric measurements of hard tissue movements were recorded.
Mean, standard deviation, and a level of statistical significance at P < .05 were used. Differences in OHIP-49 were compared using unpaired t-test. The correlation between covariates and outcomes was analyzed using the Spearman's rank test. Analysis of covariance between the predictor and outcome, adjusted for covariates (body mass index), was performed.
Fifty-four subjects with a mean age of 20.89 years and 52% males were enrolled. The mean change in UAV was 0.12 cm (standard deviation [SD] 9.21, P = .93) with a mean absolute deviation of 7.28 cm (SD 5.54). The mean change in OHIP-49 score was 20.93 (SD 28.90). Twenty-seven (50%) subjects had increased UAV (7.4 cm, SD 6.13) and the other had decreased (-7.17 cm, SD 5.01) (P = .01). At follow-up, equal levels of mean OHIP-49 score were found, but because of a baseline difference (15.74, P = .048), the subjects with and without increased UAV improved in OHIP-49 score 13.04 (SD 30.53) and 28.81 (SD 25.33), respectively (P = .04).
Because equal levels of OHIP-49 score at follow-up, changes in UAV could not be associated with patient-reported health-related quality of life. Patient-reported outcome measure evaluations of orthognathic surgical treatment for airway obstruction should be performed in patients with a perceived impairment.
正颌手术解决了牙颌面畸形患者的面部美观和功能问题。它与上呼吸道体积（UAV）的变化有关。如果无症状患者感知到 UAV 的变化则尚不清楚。
本研究旨在通过患者报告的结果测量（PROM）来测量 UAV 变化与患者报告的益处之间的关联。
回顾性研究了一组表现出牙颌面畸形但无报告呼吸问题的患者。纳入年龄在 18-30 岁之间且有 12 个月随访的患者。排除患有系统性疾病、药物滥用、精神健康障碍或颞下颌关节功能障碍的患者。
预测变量是三维计算机断层扫描测量的 UAV 变化。将受试者分为 UAV 增加或减少的组。
主要结局变量是使用口腔健康影响概况 49 项（OHIP-49）测量的健康相关生活质量变化。
体重、身高、年龄、性别和 OHIP-49 亚量表被记录。还记录了硬组织运动的头影测量。
使用平均值、标准差和 P<.05 的统计学意义水平。使用未配对 t 检验比较 OHIP-49 的差异。使用 Spearman 等级检验分析协变量和结果之间的相关性。对协变量（体重指数）进行调整后，对预测因子和结果进行协方差分析。
共纳入 54 名平均年龄为 20.89 岁、52%为男性的受试者。UAV 的平均变化为 0.12cm（标准差 [SD] 9.21，P=.93），平均绝对偏差为 7.28cm（SD 5.54）。OHIP-49 评分的平均变化为 20.93（SD 28.90）。27 名（50%）受试者的 UAV 增加（7.4cm，SD 6.13），而另一名受试者的 UAV 减少（-7.17cm，SD 5.01）（P=.01）。随访时，OHIP-49 评分的平均水平相同，但由于基线差异（15.74，P=.048），UAV 增加和减少的受试者的 OHIP-49 评分分别改善 13.04（SD 30.53）和 28.81（SD 25.33）（P=.04）。
由于随访时 OHIP-49 评分水平相同，UAV 的变化不能与患者报告的健康相关生活质量相关。对于感知到气道阻塞的患者，应进行正颌外科治疗的患者报告结局测量评估。
