Avaliação do espaço aéreo faríngeo por meio da tomografia computadorizada de feixe cônico

Zinsly, Sabrina dos Reis; Moraes, Luiz César de; Moura, Paula; Ursi, Weber

doi:10.1590/s2176-94512010000500018

Cited by 24 publications

(20 citation statements)

References 21 publications

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“…Para compreender a fisiologia e patogênese da obstrução do espaço aéreo faríngeo superior é essencial o conhecimento da morfologia e o funcionamento das estruturas esqueléticas e do tecido mole. No entanto, sua avaliação é complexa, pois sua localização não permite uma visualização direta 11 .…”

Section: Introductionunclassified

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Avaliação do espaço aéreo faríngeo pela topografia computadorizada helicoidal

2017

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RESUMOA faringe é um conduto musculomembranoso responsável pela condução dos alimentos, dos líquidos e do ar. Sua anatomia é bastante complexa devido a suas conexões ósseas, musculares e mucosas. Diversos fatores podem contribuir para a interrupção das vias aéreas superiores. A síndrome da apneia do sono é uma desordem respiratória que ocorre quando as paredes do espaço aéreo faríngeo entram em colapso. A diminuição do tamanho do espaço nasofaríngeo resulta em um desequilíbrio funcional com impacto no crescimento e desenvolvimento craniofacial. Para compreender a fisiologia e patogênese da obstrução das vias aéreas superiores (VAS) é essencial o conhecimento da morfologia e do funcionamento das estruturas esqueléticas e do tecido mole. Diversos métodos são utilizados no estudo da obstrução das VAS. A imagem do espaço aéreo superior mostra informações adicionais a respeito da anatomia do fluxo aéreo. Essas informações são úteis para direcionar o tipo de tratamento a ser realizado. Descritores: Faringe • Tomografia computadorizada por Raios X • Síndromes da apneia do sono • Apneia. ABSTRACTThe pharynx is a muscled-membranous tube responsible for the conduction of food, liquids and air. Its anatomy is quite complex due to its bone, muscle and mucous connections. Several factors may contribute to a disruption of the upper airways. The syndrome of sleep apnea is a respiratory disorder that occurs when the walls of the pharyngeal airway space collapse. When there is a size reduction of the nasopharyngeal space, the result is a functional imbalance with an impact on both craniofacial growth and development. To a better understanding of the physiology and pathogenesis of upper airway obstruction, it is essential a good knowledge of both morphology and function of skeletal structures and soft tissue. Several methods are used to study the airway obstruction. The image of the upper airspace shows additional information about the airflow anatomy. This information is useful to direct the type of treatment to be performed.

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Section: Introductionunclassified

“…Cada método possui vantagens e desvantagens que são inevitáveis, sem um consenso quanto ao procedimento padrão -ouro 11 .…”

Section: Introductionunclassified

Avaliação do espaço aéreo faríngeo pela topografia computadorizada helicoidal

2017

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“…Although it can provide a wealth of information, cephalometric radiography is limited in the sense that it produces twodimensional images (height and depth) of a three-dimensional structure, therefore hindering accurate assessment of the size and complexity of this structure. 24…”

Section: Lateral Cephalometric Radiographsmentioning

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“…Hopefully, in the near future CBCT acquisition time will be faster in order to prevent patient movements (breathing, swallowing and involuntary movements) from interfering with the results. 24…”

Section: Cbct Benefits Applications and Limitations Within Orthodonmentioning

confidence: 99%

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Impact on the Pharyngeal Airway Space after Maxillomandibular Advancement Procedure for Obstructive Sleep Apnea Patients

AlSaty¹

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Background and Objectives: Obstructive sleep apnea (OSA) is a sleep-related breathing disorder, characterized by disrupted snoring and repetitive upper airway obstructions. Continuous positive airway pressure (CPAP) is considered the therapeutic mainstay for OSA patients. However, CPAP therapy has compliance limitations. An alternative treatment options is maxillomandibular advancement (MMA) surgical procedure. Genial tubercle advancement (GTA) is often performed concomitant with MMA for esthetic purposes. Cone-beam computed tomography (CBCT) provides the ability to visualize the upper airway and perform three-dimensional (3D) reconstructions. The purpose of this study is to evaluate the impact of MMA procedure with or without GTA on oropharyngeal airway space in OSA patients and the stability after completion of orthodontic treatment. Methods: A total of 25 patients (18 females and 7 males) with a mean age of 37.1 ± 17.3 years were included in the study. CBCT scans were taken before treatment (T1); after pre-surgical orthodontic treatment (T2); immediately after MMA procedure (T3); and at 10 months follow-up visit (T4). Thus, (T2-T1) represented changes due to orthodontic treatment only; (T3-T2) represented changes due to MMA procedure; and (T4-T3) represented changes due to follow-up after surgery. Each patient served as his/her own control. Fifteen of the individuals underwent MMA with GTA. All DICOM files were analyzed using Dolphin 3D Imaging software program to determine total airway volume (TAV), airway area (AA) and minimum axial area (MAA) at explicit regions along the posterior airway space. Dolphin 3D voxel-based superimposition was used to determine the amount of skeletal advancement with MMA and changes after surgery. Results: Significant increase in TAV, AA and MAA was found with MMA treatment (40.61%; 28.77%; and 56.40%, respectively, p<.05). Smaller but significant decrease in TAV, AA and MAA was found during the 10 months follow-up visit (20%; 9.7%; and 26.8%, respectively, p<.05). No significant differences were found in airway measurements with or without GTA procedure. No significant differences were found in any of the airway measurements with or without GTA procedure. The average forward movements of the maxilla, mandible and chin were 6.56 mm and 8.21 mm, 11.42 mm, respectively and less than 1mm relapse was found during the follow-up period. No correlation was found between the magnitudes of skeletal advancement and the change in oropharyngeal airway space (OPAS). Conclusions: Significant increase in OPAS can be expected with MMA surgery with or without GTA procedure in patients diagnosed with OSA. Significant forward movement of the maxilla, mandible and chin positions can be obtained with MMA procedure. A partial loss in OPAS was found during the 10 months follow-up period. The surgical movements were found to be stable with less than 1 mm of relapse during the follow-up period, which was not clinically significant. iii DEDICATIONS To my Father, Saud, even though you are not with us anymo...

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Orthognathic Surgical Considerations for Obstructive Sleep Apnea

Kim

Movahed

2021

Management of Obstructive Sleep Apnea

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Avaliação do espaço aéreo faríngeo por meio da tomografia computadorizada de feixe cônico

Cited by 24 publications

References 21 publications

Avaliação do espaço aéreo faríngeo pela topografia computadorizada helicoidal

Avaliação do espaço aéreo faríngeo pela topografia computadorizada helicoidal

Impact on the Pharyngeal Airway Space after Maxillomandibular Advancement Procedure for Obstructive Sleep Apnea Patients

Orthognathic Surgical Considerations for Obstructive Sleep Apnea

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