NDLI: Does the Pharyngeal Airway Recover After Sagittal Split Ramus Osteotomy for Mandibular Prognathism?

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Does the Pharyngeal Airway Recover After Sagittal Split Ramus Osteotomy for Mandibular Prognathism?

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Jeon, Jae-Yun Kim, Tae-Sun Kim, Sang Yoon Park, Chang-Joo Hwang, Kyung-Gyun
Description	Author Affiliation: Jeon JY ( Clinical Lecturer, Department of Dentistry/Oral and Maxillofacial Surgery, College of Medicine, Hanyang University, Seoul, Korea.); Kim TS ( PhD Candidate, Department of Dentistry/Oral and Maxillofacial Surgery, College of Medicine, Hanyang University, Seoul); Kim SY ( Former Chief Resident, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard Medical School, Boston); Park CJ ( Associate Professor, Department of Dentistry/Oral and Maxillofacial Surgery, College of Medicine, Hanyang University, Seoul, Korea.); Hwang KG ( Professor, Department of Dentistry/Oral and Maxillofacial Surgery, College of Medicine, Hanyang University, Seoul, Korea. Electronic address: hkg@hanyang.ac.kr.)
Abstract	PURPOSE: Mandibular setback surgery can adversely affect the pharyngeal airway. The aim of this study was to investigate changes of the pharyngeal airway at specific intervals during a 12-month period after bilateral sagittal split ramus osteotomy (BSSO) for correction of mandibular prognathism. MATERIALS AND METHODS: This retrospective cohort study included patients with mandibular prognathism who underwent BSSO. The pharyngeal airway was measured at 3 different levels on lateral cephalograms: the uvula tip, the most inferior-anterior point on the body of the second cervical vertebra (low-C II), and a midanterior point on the body of the third cervical vertebra (mid-C III). The pharyngeal airway was measured preoperatively, immediately postoperatively, and 1, 3, 6, and 12 months postoperatively. The measurements at each level were compared. Multivariable analysis of variance was used to measure the changes in pharyngeal airway space over time. RESULTS: The study sample was composed of 30 patients (14 men and 16 women) who were diagnosed with mandibular prognathism. The pharyngeal airway at the uvular tip level was significantly reduced by 39% (P < .001) after surgery and was significantly improved by 26% (P < .01) from baseline at 1 month postoperatively. The pharyngeal airway at the low-C II level was significantly reduced by 27% (P < .001) after surgery and was significantly improved by 24% (P < .01) from baseline at 1 month postoperatively. The pharyngeal airway at the mid-C III level was significantly reduced by 23% (P < .001) after surgery and was improved by only 13% from baseline at 1 month postoperatively. Additional statistical changes were not noted on 3 and 6 months postoperative radiographs at all levels. The pharyngeal airway was decreased by 16, 19, and 8% from baseline at 12 months postoperatively, respectively. The upper airway length was significantly increased immediately after surgery (P < .001), but was incompletely recovered at 12 months postoperatively. CONCLUSION: The outcomes of this study indicate that the pharyngeal airway gradually recovers over time. An immediate postoperative reduction in pharyngeal airway space can induce or exacerbate obstructive sleep apnea symptoms; thus, any pre-existing symptoms should be screened and considered for surgical treatment planning.
File Format	HTM / HTML
ISSN	02782391
Issue Number	1
Volume Number	74
e-ISSN	15315053
Journal	Journal of Oral and Maxillofacial Surgery
Language	English
Publisher	Elsevier
Publisher Date	2016-01-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Medicine__semicolon__otorhinolaryngology__semicolon__surgery Osteotomy, Sagittal Split Ramus Methods Pharynx Anatomy & Histology Prognathism Surgery Adolescent Adult Anatomic Landmarks Axis Cephalometry Cervical Vertebrae Cohort Studies Female Follow-up Studies Humans Male Retrospective Studies Treatment Outcome Uvula Young Adult Comparative Study Journal Article Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Oral Surgery Otorhinolaryngology Surgery

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