Taşkıran G, Meral S E, El H, Tüz H H
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.
Department of Orthodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.
Int J Oral Maxillofac Surg. 2025 Sep 12. doi: 10.1016/j.ijom.2025.08.013.
This retrospective study was performed to evaluate the effect of maxillomandibular surgery on upper airway volumes and hyoid bone positioning in patients with Class III skeletal deformities, treated with maxillary advancement and mandibular setback, with/without a concomitant genioplasty. The study involved 43 patients, divided into two groups: BiMax (bimaxillary surgery with Le Fort I osteotomy and mandibular setback) and BiMax + G (the same surgery with an advancement genioplasty). Changes in nasopharynx, oropharynx, and hypopharynx volumes and position of the hyoid bone were assessed using pre- and postoperative CBCT scans. The data were analysed using t-tests, the Mann-Whitney U-test, and the Wilcoxon signed rank test. The patients in both groups showed a significant increase in nasopharyngeal volume post-surgery (BiMax, P = 0.009; BiMax + G, P = 0.001); however, the change in volume did not differ significantly between the groups. Furthermore, the hypopharyngeal volume increased significantly in the BiMax + G group (P = 0.025), but there was no statistically significant difference in volume change between the groups. There was no statistically significant between-group difference in the change in oropharyngeal or total pharyngeal volume. However, a significant difference was observed in the change in H-RGn distance between the groups (P = 0.021), indicating a differential effect on this hyoid-related parameter. Further exploration of the effects of genioplasty on the upper airway is necessary in future studies.
本回顾性研究旨在评估上颌前徙和下颌后退术(伴或不伴颏成形术)治疗Ⅲ类骨骼畸形患者时,上下颌手术对上气道容积和舌骨位置的影响。该研究纳入43例患者,分为两组:双颌手术组(采用Le Fort I型截骨术和下颌后退的双颌手术)和双颌手术+颏成形术组(相同手术加颏前徙成形术)。使用术前和术后的锥形束CT扫描评估鼻咽、口咽和下咽的容积变化以及舌骨位置。采用t检验、Mann-Whitney U检验和Wilcoxon符号秩检验对数据进行分析。两组患者术后鼻咽容积均显著增加(双颌手术组,P = 0.009;双颌手术+颏成形术组,P = 0.001);然而,两组间容积变化无显著差异。此外,双颌手术+颏成形术组下咽容积显著增加(P = 0.025),但两组间容积变化无统计学显著差异。两组间口咽或总咽容积变化无统计学显著差异。然而,两组间H-RGn距离变化存在显著差异(P = 0.021),表明对该舌骨相关参数有不同影响。未来研究有必要进一步探讨颏成形术对上气道的影响。