Maxillofacial Plastic and Reconstructive Surgery

  • 제38권
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  • Pages.23.1-23.7
  • /
  • 2016
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  • 2288-8101(pISSN)
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  • 2288-8586(eISSN)
대한악안면성형재건외과학회 (Korean Association of Maxillofacial Plastic and Reconstructive Surgeons)
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Change of the airway space in mandibular prognathism after bimaxillary surgery involving maxillary posterior impaction

  • Lee, Woo-Young (Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University) ;
  • Park, Young-Wook (Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University) ;
  • Kwon, Kwang-Jun (Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University) ;
  • Kim, Seong-Gon (Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University)
  • 투고 : 2016.02.17
  • 심사 : 2016.05.19
  • 발행 : 2016.12.31
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초록

Background: The purpose of this retrospective study was to develop a two- and three-dimensional analysis of the airway using cone-beam computed tomography (CBCT) and to determine whether the airway space would be changed in mandibular prognathism after bimaxillary surgery involving maxillary posterior impaction. Methods: Patients requiring orthognathic surgery from 2012 to 2014 were recruited for this study. CBCT scans were obtained at three points: preoperatively (T0), immediate postoperatively (T1), and after 6 months postoperatively (T2). The nasopharynx, oropharynx, and hypopharynx were measured on the CBCT scan for each patient in a repeatable manner. With the midsagittal plane, linear measurements in the middle of each were obtained. For the CBCT, volumetric measurements of each and total airway were obtained. Results: A total of 22 consecutive patients (11 men and 11 women) were included in the present study. The total volume was significantly reduced (p < .001). However, the change of the diameter and volume of the nasopharynx was not statistically significant (p = .160, p = .137, respectively). In the oropharynx, the change of both the diameter and volume showed statistical significance between preoperatively and immediate postoperatively (p < .001, p = .001, respectively) and also preoperatively and after 6 months postoperatively (p = .001, p = .010, respectively). In the hypopharynx, the change of both the diameter and volume showed statistical significance between preoperatively and immediate postoperatively (p = .001, p < .001, respectively) and also preoperatively and after 6 months postoperatively (p = .001, p < .001, respectively). Conclusions: The bimaxillary surgery involving maxillary posterior impaction can reduce the volume of airway in the patients of mandibular prognathism. Although total airway volume was reduced significantly, the changes in the volume and diameter of the nasopharynx were not statistically significant. The maxillary posterior impaction affects on the nasopharyngeal airway minimally.

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참고문헌

  1. Gokce S, Gorgulu S, Gokce H et al (2012) Changes in posterior airway space, pulmonary function and sleep quality, following bimaxillary orthognathic surgery. Int J Oral Maxillofac Surg 41(7):820-829 https://doi.org/10.1016/j.ijom.2012.01.003
  2. Chen F, Terada K, Hua Y, Saito I (2007) Effects of bimaxillary surgery and mandibular setback surgery on pharyngeal airway measurements in patients with class III skeletal deformities. Am J Orthod Dentofacial Orthop 131(3):372-377 https://doi.org/10.1016/j.ajodo.2005.06.028
  3. Becker OE, Avelar RL, Goelzer JG, Do Nascimento Dolzan A, Junior OLH, De Oliveira RB (2012) Pharyngeal airway changes in class III patients treated with double jaw orthognathic surgery-maxillary advancement and mandibular setback. J Oral Maxillofac Surg 70(11):e639-47 https://doi.org/10.1016/j.joms.2012.07.052
  4. Wolford LM, Perez D, Stevao E, Perez E (2012) Airway space changes after nasopharyngeal adenoidectomy in conjunction with Le Fort I osteotomy. J Oral Maxillofac Surg 70(3):665-671 https://doi.org/10.1016/j.joms.2011.02.069
  5. De Souza CA, Magro Filho O, Garcia I, Araujo P, Nogueira R (2012) Cephalometric and three-dimensional assessment of superior posterior airway space after maxillomandibular advancement. Int J Oral Maxillofac Surg 41(9):1102-1111 https://doi.org/10.1016/j.ijom.2012.05.009
  6. Mattos C, Vilani G, Sant'Anna E, Ruellas A, Maia L (2011) Effects of orthognathic surgery on oropharyngeal airway: a meta-analysis. Int J Oral Maxillofac Surg 40(12):1347-1356 https://doi.org/10.1016/j.ijom.2011.06.020
  7. Foltan R, Hoffmannova J, Pavlikova G et al (2011) The influence of orthognathic surgery on ventilation during sleep. Int J Oral Maxillofac Surg 40(2):146-149 https://doi.org/10.1016/j.ijom.2010.10.006
  8. Guijarro-Martinez R, Swennen G (2013) Three-dimensional cone beam computed tomography definition of the anatomical subregions of the upper airway: a validation study. Int J Oral Maxillofac Surg 42(9):1140-1149 https://doi.org/10.1016/j.ijom.2013.03.007
  9. Guijarro-Martinez R, Swennen G (2011) Cone-beam computerized tomography imaging and analysis of the upper airway: a systematic review of the literature. Int J Oral Maxillofac Surg 40(11):1227-1237 https://doi.org/10.1016/j.ijom.2011.06.017
  10. Souza KRS, Oltramari-Navarro PVP, Navarro RL, Conti ACCF, Almeida MR (2013) Reliability of a method to conduct upper airway analysis in cone-beam computed tomography. Braz Oral Res 27(1):48-54 https://doi.org/10.1590/S1806-83242013000100009
  11. Stratemann S, Huang JC, Maki K, Hatcher D, Miller AJ (2011) Three-dimensional analysis of the airway with cone-beam computed tomography. Am J Orthod Dentofacial Orthop 140(5):607-615 https://doi.org/10.1016/j.ajodo.2010.12.019
  12. Demetriades N, Chang DJ, Laskarides C, Papageorge M (2010) Effects of mandibular retropositioning, with or without maxillary advancement, on the oro-naso-pharyngeal airway and development of sleep-related breathing disorders. J Oral Maxillofac Surg 68(10):2431-2436 https://doi.org/10.1016/j.joms.2010.02.033
  13. Park J-W, Kim N-K, Kim J-W, Kim M-J, Chang Y-I (2010) Volumetric, planar, and linear analyses of pharyngeal airway change on computed tomography and cephalometry after mandibular setback surgery. Am J Orthod Dentofacial Orthop 138(3):292-299 https://doi.org/10.1016/j.ajodo.2009.10.036
  14. Kim M-A, Kim B-R, Choi J-Y, Youn J-K, Kim Y-JR, Park Y-H (2013) Threedimensional changes of the hyoid bone and airway volumes related to its relationship with horizontal anatomic planes after bimaxillary surgery in skeletal class III patients. Angle Orthod 83(4):623-629 https://doi.org/10.2319/083112-700.1
  15. Riley RW, Powell NB, Guilleminault C (1990) Maxillary, mandibular, and hyoid advancement for treatment of obstructive sleep apnea: a review of 40 patients. J Oral Maxillofac Surg 48(1):20-26 https://doi.org/10.1016/0278-2391(90)90174-Z
  16. Partinen M, Guilleminault C, Quera-Salva M, Jamieson A (1988) Obstructive sleep apnea and cephalometric roentgenograms. The role of anatomic upper airway abnormalities in the definition of abnormal breathing during sleep. Chest 93(6):1199-1205 https://doi.org/10.1378/chest.93.6.1199
  17. Sears CR, Miller AJ, Chang MK, Huang JC, Lee JS (2011) Comparison of pharyngeal airway changes on plain radiography and cone-beam computed tomography after orthognathic surgery. J Oral Maxillofac Surg 69(11):e385-e394 https://doi.org/10.1016/j.joms.2011.03.015
  18. Hernandez-Alfaro F, Guijarro-Martinez R, Mareque-Bueno J (2011) Effect of mono-and bimaxillary advancement on pharyngeal airway volume: cone-beam computed tomography evaluation. J Oral Maxillofac Surg 69(11):e395-e400 https://doi.org/10.1016/j.joms.2011.02.138
  19. Mattos CT, Cruz CV, Da Matta TCS et al (2014) Reliability of upper airway linear, area, and volumetric measurements in cone-beam computed tomography. Am J Orthod Dentofacial Orthop 145(2):188-197 https://doi.org/10.1016/j.ajodo.2013.10.013
  20. Vizzotto MB, Liedke GS, Delamare EL, Silveira HD, Dutra V, Silveira HE (2012) A comparative study of lateral cephalograms and cone-beam computed tomographic images in upper airway assessment. Eur J Orthod 34(3):390-393 https://doi.org/10.1093/ejo/cjr012
  21. Hasebe D, Kobayashi T, Hasegawa M et al (2011) Changes in oropharyngeal airway and respiratory function during sleep after orthognathic surgery in patients with mandibular prognathism. Int J Oral Maxillofac Surg 40(6):584-592 https://doi.org/10.1016/j.ijom.2011.01.011
  22. Pereira-Filho VA, Castro-Silva LM, De Moraes M, Gabrielli MFR, Campos JADB, Juergens P (2011) Cephalometric evaluation of pharyngeal airway space changes in class III patients undergoing orthognathic surgery. J Oral Maxillofac Surg 69(11):e409-e415 https://doi.org/10.1016/j.joms.2011.02.132
  23. Foltan R, Hoffmannova J, Donev F et al (2009) The impact of Le Fort I advancement and bilateral sagittal split osteotomy setback on ventilation during sleep. Int J Oral Maxillofac Surg 38(10):1036-1040 https://doi.org/10.1016/j.ijom.2009.06.001
  24. Lee Y, Chun Y-S, Kang N, Kim M (2012) Volumetric changes in the upper airway after bimaxillary surgery for skeletal class III malocclusions: a case series study using 3-dimensional cone-beam computed tomography. J Oral Maxillofac Surg 70(12):2867-2875 https://doi.org/10.1016/j.joms.2012.03.007
  25. Choi S-K, Yoon J-E, Cho J-W, Kim J-W, Kim S-J, Kim M-R (2014) Changes of the airway space and the position of hyoid bone after mandibular set back surgery using bilateral sagittal split ramus osteotomy technique. Maxillofac Plast Reconstr Surg 36:185-191 https://doi.org/10.14402/jkamprs.2014.36.5.185

피인용 문헌

  1. The structural changes of pharyngeal airway contributing to snoring after orthognathic surgery in skeletal class III patients vol.39, pp.None, 2017, https://doi.org/10.1186/s40902-017-0120-6