Maxillofacial Plastic and Reconstructive Surgery

  • Volume 37
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  • Pages.38.1-38.6
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  • 2015
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  • 2288-8101(pISSN)
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  • 2288-8586(eISSN)
Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
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Retrospective study of changes in pharyngeal airway space and position of hyoid bone after mandibular setback surgery by cephalometric analysis

  • Cho, Hyun-Woo (Department of Oral and Maxillofacial Surgery, College of Medicine, Inha University) ;
  • Kim, Il-Kyu (Department of Oral and Maxillofacial Surgery, College of Medicine, Inha University) ;
  • Cho, Hyun-Young (Department of Oral and Maxillofacial Surgery, College of Medicine, Inha University) ;
  • Seo, Ji-Hoon (Department of Oral and Maxillofacial Surgery, College of Medicine, Inha University) ;
  • Lee, Dong-Hwan (Department of Oral and Maxillofacial Surgery, College of Medicine, Inha University) ;
  • Park, Seung-Hoon (Department of Oral and Maxillofacial Surgery, International St. Mary's Hospital, Catholic Kwandong University College of Medicine)
  • Received : 2015.08.26
  • Accepted : 2015.10.15
  • Published : 2015.12.31
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Abstract

Background: The posterior movement of mandible was known as the main cause of the changes in the pharyngeal airway space (PAS) and the postoperative obstructive sleep apnea (OSA). The purpose of this study was to know the changes of PAS and position of hyoid bone. Methods: Lateral cephalographies of 13 patients who had undergone sagittal split ramus osteotomy (SSRO) setback surgery were taken preoperatively (T1), postoperatively within 2 months (T2), and follow-up after 6 months or more (T3). On the basis of F-H plane, diameters of nasopharynx, oropharynx, and hypopharynx were measured. The movements of the soft palate, tongue, and hyoid bone were also measured. Results: The amount of mandible setback was $7.5{\pm}3.8mm$. In the measurements of PAS, there was a statistically significant decrease of $2.8{\pm}2.5mm$ in nasopharynx (P < 0.01), and $1.7{\pm}2.4mm$ in oropharynx (P < 0.01) were observed after surgery. The hypopharynx decreased $1.0{\pm}2.1mm$ after surgery and continuously decreased $1.0{\pm}2.8mm$ at follow-up. The changes in hyoid bone position showed the posterior movement only after surgery and posteroinferior movement at follow-up. Conclusions: The PAS such as nasopharynx, oropharynx, and hypopharynx showed relatively high correlation with the amount of mandibular setback. The change of resistance in upper airway may be important for the prevention of OSA after mandibular setback surgery.

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References

  1. Greco JM, Frohberg U, Van Sickels JE (1990) Long-term airway space changes after mandibular setback using bilateral sagittal split osteotomy. Int J Oral Maxillofac Surg 19(2):103-5 https://doi.org/10.1016/S0901-5027(05)80204-8
  2. Lindberg E, Janson C, Svardsudd K, Gislason T, Hetta J, Boman G (1998) Increased mortality among sleepy snorers: a prospective population based study. Thorax 53(8):631-7 https://doi.org/10.1136/thx.53.8.631
  3. Li D, Liu D, Wang X, He D (2014) Self-reported habitual snoring and risk of cardiovascular disease and all-cause mortality. Atherosclerosis 235(1):189-195 https://doi.org/10.1016/j.atherosclerosis.2014.04.031
  4. Riley RW, Powell NB, Guilleminault C, Ware W (1987) Obstructive sleep apnea syndrome following surgery for mandibular prognathism. J Oral Maxillofac Surg 45(5):450-2 https://doi.org/10.1016/0278-2391(87)90016-4
  5. Stradling JR, Crosby JH (1991) Predictors and prevalence of obstructive sleep apnoea and snoring in 1001 middle aged men. Thorax 46(2):85-90 https://doi.org/10.1136/thx.46.2.85
  6. Eggensperger N, Smolka W, Iizuka T (2005) Long-term changes of hyoid bone position and pharyngeal airway size following mandibular setback by sagittal split ramus osteotomy. J Craniomaxillofac Surg 33(2):111-7 https://doi.org/10.1016/j.jcms.2004.10.004
  7. Saitoh K (2004) Long-term changes in pharyngeal airway morphology after mandibular setback surgery. Am J Orthod Dentofacial Orthop 125(5):556-61 https://doi.org/10.1016/j.ajodo.2003.04.017
  8. Pereira-Filho VA, Castro-Silva LM, de Moraes M, Gabrielli MF, Campos JA, Juergens P (2011) Cephalometric evaluation of pharyngeal airway space changes in class III patients undergoing orthognathic surgery. J Oral Maxillofac Surg 69(11):e409-15 https://doi.org/10.1016/j.joms.2011.02.132
  9. Marsan G, Cura N, Emekli U (2008) Changes in pharyngeal (airway) morphology in class III Turkish female patients after mandibular setback surgery. J Craniomaxillofac Surg 36(6):341-5 https://doi.org/10.1016/j.jcms.2008.03.001
  10. Kitagawara K, Kobayashi T, Goto H, Yokobayashi T, Kitamura N, Saito C (2008) Effects of mandibular setback surgery on oropharyngeal airway and arterial oxygen saturation. Int J Oral Maxillofac Surg 37(4):328-33 https://doi.org/10.1016/j.ijom.2007.12.005
  11. Abdelrahman TE, Takahashi K, Tamura K, Nakao K, Hassanein KM, Alsuity A (2011) Impact of different surgery modalities to correct class III jaw deformities on the pharyngeal airway space. J Craniofac Surg 22(5):1598-601 https://doi.org/10.1097/SCS.0b013e31822e5fc2
  12. Turnbull NR, Battagel JM (2000) The effects of orthognathic surgery on pharyngeal airway dimensions and quality of sleep. J Orthod 27(3):235-47 https://doi.org/10.1179/ortho.27.3.235
  13. Greco JM, Frohberg U, Van Sickels JE (1990) Cephalometric analysis of long-term airway space changes with maxillary osteotomies. Oral Surg Oral Med Oral Pathol 70(5):552-4 https://doi.org/10.1016/0030-4220(90)90394-8
  14. Liukkonen M, Vahatalo K, Peltomaki T, Tiekso J, Happonen RP (2002) Effect of mandibular setback surgery on the posterior airway size. Int J Adult Orthodon Orthognath Surg 17(1):41-6
  15. Tselnik M, Pogrel MA (2000) Assessment of the pharyngeal airway space after mandibular setback surgery. J Oral Maxillofac Surg 58(3):282-5 https://doi.org/10.1016/S0278-2391(00)90053-3
  16. Gu G, Nagata J, Suto M, Anraku Y, Nakamura K, Kuroe K (2000) Hyoid position, pharyngeal airway and head posture in relation to relapse after the mandibular setback in skeletal class III. Orthod Res 3(3):67-77 https://doi.org/10.1034/j.1600-0544.2000.030203.x
  17. Kitahara T, Hoshino Y, Maruyama K, In E, Takahashi I (2010) Changes in the pharyngeal airway space and hyoid bone position after mandibular setback surgery for skeletal class III jaw deformity in Japanese women. Am J Orthod Dentofacial Orthop 138(6):708.e1-10 https://doi.org/10.1016/j.ajodo.2010.06.014
  18. Athanasiou AE, Toutountzakis N, Mavreas D, Ritzau M, Wenzel A (1991) Alterations of hyoid bone position and pharyngeal depth and their relationship after surgical correction of mandibular prognathism. Am J Orthod Dentofacial Orthop 100(3):259-65 https://doi.org/10.1016/0889-5406(91)70063-3
  19. Degerliyurt K, Ueki K, Hashiba Y, Marukawa K, Nakagawa K, Yamamoto E (2008) A comparative CT evaluation of pharyngeal airway changes in class III patients receiving bimaxillary surgery or mandibular setback surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 105(4):495-502 https://doi.org/10.1016/j.tripleo.2007.11.012
  20. Kawamata A, Fujishita M, Ariji Y, Ariji E (2000) 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(3):278-87 https://doi.org/10.1016/S1079-2104(00)70089-8
  21. Tomoko U, Yoshiyasu Y, Yukiko Y, Nobuyuki A, Akira T, Tadashi O (2012) A comparative study on the morphological changes in the pharyngeal airway space before and after sagittal split ramus osteotomy. J Hard Tissue Biology 21(1):35-42 https://doi.org/10.2485/jhtb.21.35
  22. Kim IK, Kim KD, Jung EH (1997) A study of the pharyngeal size in the skeletal patterns: a cephalometric evaluation. J Korean Assoc Oral Maxillofac Surg 23(2):311-321
  23. Susarla SM, Thomas RJ, Abramson ZR, Kaban LB (2010) Biomechanics of the upper airway: changing concepts in the pathogenesis of obstructive sleep apnea. Int J Oral Maxillofac Surg 39(12):1149-59 https://doi.org/10.1016/j.ijom.2010.09.007

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