Zou Yiwen, Yang Ruicong, Yeweng San-Jie, Wu Zhongxing
State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China.
Department of Oral and Maxillofacial Surgery, Stomatology School and Hospital of Peking University, Beijing, China.
J Craniofac Surg. 2024 Mar 6. doi: 10.1097/SCS.0000000000010020.
In recent years, maxillary Le Fort I osteotomy setback has been widely applied in correcting maxilla prognathism. In the meantime, airway considerations have attracted more and more attention. The aim of this research was to observe the alteration of nasopharyngeal airway indexes after maxilla setback and offer evidence for the effectiveness and safety of maxillary Le Fort I setback surgeries. As for a retrospective cross-sectional study, 40 patients diagnosed with maxilla prognathism and undergoing maxillary setback surgeries were enrolled. They were grouped by the type of maxillary setback operations as group A (integral maxillary setback, n=19) and group B (segmental maxillary setback, n=21). Multislice computed tomography data were collected 1 week before (T0) and more than 3 months (T1) after surgery. 3D reconstruction and evaluation of the pharyngeal airway were conducted to analyze nasopharyngeal airway index variation before and after surgery and the difference between group A and group B. Preoperative and postoperative nasopharyngeal airway volume showed no statistical significance in group A (P=0.872) and group B (P=0.169) as well as other indexes of the nasopharynx. The comparison of postoperative airway changes between group A and group B also showed no significant difference. Both integral and segmental maxillary Le Fort I osteotomy setbacks have slight impact on nasopharyngeal airway dimensions and are safe within a specific setback range.
近年来，上颌骨Le Fort I型截骨后退术已广泛应用于矫正上颌前突。与此同时，气道相关因素越来越受到关注。本研究旨在观察上颌骨后退术后鼻咽气道指标的变化，为上颌骨Le Fort I型后退术的有效性和安全性提供依据。作为一项回顾性横断面研究，纳入了40例诊断为上颌前突并接受上颌骨后退手术的患者。根据上颌骨后退手术类型将他们分为A组（整体上颌骨后退，n = 19）和B组（分段上颌骨后退，n = 21）。在术前1周（T0）和术后3个月以上（T1）收集多层计算机断层扫描数据。对咽气道进行三维重建和评估，分析手术前后鼻咽气道指标的变化以及A组和B组之间的差异。A组（P = 0.872）和B组（P = 0.169）的术前和术后鼻咽气道容积以及鼻咽的其他指标均无统计学意义。A组和B组术后气道变化的比较也无显著差异。整体和分段上颌骨Le Fort I型截骨后退术对鼻咽气道尺寸的影响均较小，在特定的后退范围内是安全的。
