Maxillofacial Plastic and Reconstructive Surgery

Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
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CHANGES IN HYOID BONE AND TONGUE POSITIONS, AND ORAL CAVITY VOLUME AFTER MANDIBULAR SETBACK BY SAGITTAL SPLIT RAMUS OSTEOTOMY

  • Liang, Shan-Shan (Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University) ;
  • Chu, Yeon-Gyu (Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University) ;
  • Choi, So-Young (Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University) ;
  • Lee, Sang-Han (Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University) ;
  • Park, In-Suk (Department of Dentistry(Oral and Maxillofacial Surgery), School of Medicine, Keimyung University) ;
  • Deng, Fang-Cheng (Department of Oral and Maxillofacial Surgery, College of Dentistry, Affiliated Hospital of Hainan Medical College)
  • Published : 2009.07.31
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Abstract

Purpose: This retrospective study evaluated the changes in hyoid bone and tongue positions as well as oral cavity volume after mandibular setback by BSSRO. Materials and Methods: 18 Koreans who underwent BSSRO to correct mandibular prognathism were studied. Lateral cephalograms were taken and traced preoperatively (T0), immediately (T1) and approximately 6 months postoperatively (T2). Submentovertex radiograghs were taken and traced before surgery (T0) and about 6 months after surgery (T2). The area and volume of oral cavity, the vertical and horizontal dimensions of the hyoid bone and tongue dorsum were measured. Results: Mandibular setback surgery resulted in a significant reduction of lower oral cavity volume. The hyoid bone displaced posteroinferiorly immediately after surgery, and it tended to return to its original vertical position at 6 month after mandibular setback by BSSRO. The retropalatal space around tongue was maintained and the retrolingual space around tongue was reduced immediately postoperatively. The readaptation of tongue was not evident for that the follow up period was not long enough. No significant statistical correlations between the amounts of mandibular setback and the changes of oral cavity volume were observed. Conclusion: Mandibular setback surgery resulted in a significant reduction of lower oral cavity volume, which was most likely attributable to the posterior movement of the mandible. More subjects and long-term observations should be performed to assess the changes of oropharyngeal configuration following mandibular setback surgery.

Keywords

References

  1. Chen F, Terada K, Hua Y et al : Effects of bimaxillary surgery and mandibular setback surgery on pharyngeal airway measurements in patients with Class III skeletal deformities. Am J Orthod Dentofac Orthop 131 : 372, 2007 https://doi.org/10.1016/j.ajodo.2005.06.028
  2. Wickwire NA, White RP Jr, Proffit WR : The effect of mandibular osteotomy on tongue position. J Oral Surg 30 : 184, 1972
  3. Enacar A, Aksoy AU, Sencift Y et al : Changes in hypopharyngeal airway space and in tongue and hyoid bone positions following the surgical correction of mandibular prognathism. Int J Adult Orthod Orthognath Surg 9 : 285, 1994
  4. Greco JM, Frohberg U, Van Sickels JE : Long-term airway space changes after mandibular setback using bilateral sagittal split osteotomy. Int J Oral Maxillofac Surg 19 : 103, 1990 https://doi.org/10.1016/S0901-5027(05)80204-8
  5. Tselnik M, Pogrel MA : Assessment of the pharyngeal airway space after mandibular setback surgery. J Oral Maxillofac Surg 58 : 282, 2000 https://doi.org/10.1016/S0278-2391(00)90053-3
  6. Kawamata A, Fujishita M, Ariji Y et al : Three-dimensional computed tomographic evaluation of morphologic airway changes after mandibular setback osteotomy for prognathism. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 89 : 278, 2000 https://doi.org/10.1016/S1079-2104(00)70089-8
  7. Achilleos S, Krogstad O, Lyberg T : Surgical mandibular setback and changes in uvuloglossopharyngeal morphology and head posture : A short and long-term cephalometric study in males. Eur J Orthod 22 : 383, 2000 https://doi.org/10.1093/ejo/22.4.383
  8. Eggensperger N, Smolka W, Iizuka W : Long-term changes of hyoid bone position and pharyngeal airway size following mandibular setback by sagittal split ramus osteotomy. J Cranio-Maxillofac Surg 33 : 111, 2005 https://doi.org/10.1016/j.jcms.2004.10.004
  9. G$\ddot{u}$ven O, Saracoglu U : Changes in pharyngeal airway space and hyoid bone positions after body osteotomies and sagittal split ramus osteotomies. J Craniofac Surg 16 : 23, 2005 https://doi.org/10.1097/00001665-200501000-00007
  10. Athanasiou AE, Toutountzakis N, Mavreas D et al : Alterations of hyoid bone position and pharyngeal depth and their relationship after surgical correction of mandibular prognathism. Am J Orthod Dentofac Orthop, 100 : 259, 1991 https://doi.org/10.1016/0889-5406(91)70063-3
  11. Samman N, Tang SS, Xia J : Cephalometric study of the upper airway in surgically corrected class III skeletal deformity. Int J Adult Orthodon Orthognath Surg 17 : 180, 2002
  12. Saitoh K : Long-term changes in pharyngeal airway morphology after mandibular setback surgery. Am J Orthod Dentofac Orthoped 125 : 556, 2004 https://doi.org/10.1016/j.ajodo.2003.04.017
  13. Kawakami M, Yamamoto K, Fujimoto M et al : Changes in tongue and hyoid positions, and posterior airway space following mandibular setback surgery. J Cranio-Maxillofac Surg 33 : 107, 2005 https://doi.org/10.1016/j.jcms.2004.10.005
  14. Gu GM, Gu G, Nagata J et al : Hyoid position, pharyngeal airway and head posture in relation to relapse after the mandibular setback in skeletal Class III. Clin Orthod Res 3 : 67, 2000 https://doi.org/10.1034/j.1600-0544.2000.030203.x
  15. Liukkonen M, V$\ddot{a}$h$\ddot{a}$talo K, Peltom$\ddot{a}$ki T et al : Effect of mandibular setback surgery on the posterior airway size. Int J Adult Orthod Orthognath Surg 17 : 41, 2002
  16. Lee SH, Nam JH, Jung CW et al : The positional relationship between the mandible and the hyoid bone in mandibualr protrusion after orthognathic surgery evaluated with 3-D CT. J Kor Oral Maxillofac Surg 29 : 173, 2003
  17. Marsan G, Cura N, Emekli U : Changes in pharyngeal (airway) morphology in Class III Turkish female patients after mandibular setback surgery. J Cranio-Maxillofac Surg 36: 341, 2008 https://doi.org/10.1016/j.jcms.2008.03.001
  18. Riley R, Powell N, Guilleminault C et al : Obstructive sleep apnea syndrome following surgery for mandibular prognathism. J Oral Maxillofac Surg 45 : 450, 1987 https://doi.org/10.1016/0278-2391(87)90016-4
  19. Kitagawara K, Kobayashi T, Goto H et al : Effects of mandibular setback surgery on oropharyngeal airway and arterial oxygen saturation. Int J Oral Maxillofac Surg 37 : 328, 2008 https://doi.org/10.1016/j.ijom.2007.12.005
  20. Hoekema A, Hovinga B, Stegenga B et al : Craniofacial morphology and obstructive sleep apnea: A cephalometric analysis. J Oral Rehabil 30 : 690, 2003 https://doi.org/10.1046/j.1365-2842.2003.01130.x
  21. Lew KKK : Changes in tongue and hyoid bone positions following anterior mandibular subapical osteotomy in patients with Class III malocclusion. Int J Adult Orthod Orthognath Surg 8 : 123, 1993
  22. Park BW, Kim JR : A cephalometric study on changes in pharyngeal airway space, tongue and hyoid bone positions following the surgical correction of mandibular prognathism. J Kor Oral Maxillofac Surg 26 : 164, 2000
  23. Lye KW : Effect of orthognathic surgery on the posterior airway space (PAS). Ann Acad Med 37 : 677, 2008
  24. Lee KH, Hwang YI, Kim YJ et al : Changes in tongue position, airway width, gonial angle, lower facial height after bilateral sagittal split ramus osteotomy in mandibular prognathic patients. J Kor Oral Maxillofac Surg 33 : 109, 2007