Grab Paweł Piotr, Szałwiński Michał, Jagielak Maciej, Rożko Jacek, Jurkiewicz Dariusz, Chloupek Aldona, Sobol Maria, Rot Piotr
Clinical Department of Cranio-Maxillo-Facial Surgery, Military Institute of Medicine-National Research Institute, Szaserów 128, 04-141 Warsaw, Poland.
Department of Dental and Maxillofacial Radiology, Medical University of Warsaw, 02-097 Warsaw, Poland.
J Clin Med. 2024 Aug 6;13(16):4588. doi: 10.3390/jcm13164588.
: Bimaxillary surgeries (BiMax) are an essential part of the craniomaxillofacial specialty. The osteotomies and subsequent spatial rearrangement of the maxilla and the mandible enable the correction of facial deformities, asymmetry, and malocclusion. Moreover, the movements performed during the procedure affect the morphology of surrounding soft tissues, including the upper airway (UA). The objective of this study was to radiologically assess the potential volumetric alterations of the UA in the supine position at various intervals following BiMax advancement surgeries. : A group of 31 patients who underwent BiMax advancement surgery were included in the study. Medical computed tomography (CT) of the head and neck region was performed 2 weeks preoperatively, 1 day postoperatively, and 6 months postoperatively. The UA volumes were calculated and analyzed based on the acquired Digital Imaging and Communications in Medicine (DICOM) files using different software applications. The sella-nasion-A point (SNA) and sella-nasion-B point (SNB) angles were evaluated to measure the achieved maxillomandibular advancement. : When comparing the volume of the UA before surgery, post-surgery, and 6 months post-surgery, the -value was <0.001, indicating statistically significant differences in UA volume between the successive examinations. A statistically significant difference was found between UA volume before surgery and 6 months post-surgery and between UA volume after surgery and 6 months post-surgery, with the obtained -values being <0.001 and 0.001, respectively. A significantly larger UA volume was observed 6 months post-surgery (mean ± SD: 27.3 ± 7.3) compared to the volume before surgery (mean ± SD: 22.2 ± 6.4), as well as 6 months post-surgery compared to the volume assessed shortly after surgery (mean ± SD: 24.2 ± 7.3). : BiMax advancement surgeries result in the significant enlargement of the UA. The volume of the UA does not diminish immediately following the procedure and is not constant; it increases significantly during the postoperative observation period.
双颌手术(BiMax)是颅颌面外科专业的重要组成部分。上颌骨和下颌骨的截骨术以及随后的空间重排能够矫正面部畸形、不对称和错牙合。此外,手术过程中进行的移动会影响周围软组织的形态,包括上气道(UA)。本研究的目的是通过影像学评估双颌前徙手术后不同时间间隔仰卧位时上气道的潜在容积变化。
本研究纳入了一组31例行双颌前徙手术的患者。术前2周、术后1天和术后6个月对头颈部区域进行医学计算机断层扫描(CT)。使用不同的软件应用程序根据获取的医学数字成像和通信(DICOM)文件计算并分析上气道容积。评估蝶鞍-鼻根-A点(SNA)和蝶鞍-鼻根-B点(SNB)角度以测量实现的上下颌前徙情况。
比较术前、术后及术后6个月的上气道容积时,P值<0.001,表明连续检查之间上气道容积存在统计学显著差异。术前与术后6个月以及术后与术后6个月的上气道容积之间均发现有统计学显著差异,获得的P值分别为<0.001和0.001。与术前容积(均值±标准差:22.2±6.4)相比,术后6个月观察到上气道容积显著增大(均值±标准差:27.3±7.3),与术后不久评估的容积(均值±标准差:24.2±7.3)相比也是如此。
双颌前徙手术导致上气道显著扩大。上气道容积在手术后不会立即减小且并非恒定不变;在术后观察期内会显著增加。