Cephalometric evaluation of the pharyngeal airway space after orthognathic surgery and distraction osteogenesis of the jaw bones

Abstract

Objective:Orthognathic surgeries and distraction osteogenesis (DO) of the jaw bones cause a change in the pharyngeal airway space (PAS). The aim of our study was to evaluate the magnitude of changes occurring in the pharyngeal airway after mandibular set-back surgeries and DO of maxilla/mandible.Materials and Methods:The study undertaken was a retrospective cephalometric study. Subjects included in our study had undergone mandibular set-back surgery or DO of maxilla/mandible. Lateral cephalograms of the subjects taken pre-operatively (T0), immediate post-operatively (T1) and after a minimum follow-up period of 6 months (T2) were studied. The cephalograms were traced manually and the following parameters were evaluated: Surface area of the PAS, pharyngeal airway width at the level of the base of the tongue, position of the hyoid bone and the tongue. Repeated measure ANOVA test was done to assess the presence of any significant changes in the proposed parameters at T0, T1 and T2. A correlation analysis was made between the mandibular/maxillary movements and the corresponding changes in the PAS.Results:Surgical movements of maxilla and mandible do have an effect on the pharyngeal airway.Conclusion:It was clearly evident that the effects of mandibular movements on the PAS and the hyoid bone is more significant than the maxillary movements.

Effects of maxillomandibular advancement surgery on a skeletal Class III patient with obstructive sleep apnea: A case report

“…e lateral cephalogram showed a narrow posterior airway space at the level of the base of the tongue [Figure 3]. [15] Treatment objectives e treatment objectives for this patient included orthodontic, surgical, and prosthodontic treatment to correct the maxillary transverse discrepancy, improve dental alignment, create space for prosthetic replacement of the upper missing lateral incisors, establish overbite and overjet for proper function, and improve soft-tissue profile. In addition, the treatment objectives included enlargement of the posterior airway space to relieve sleep apnea.…”

3D Airway changes using cone beam computed tomography in patients following mandibular advancement surgery with and without constriction

“…Previous investigations have demonstrated that mandibular advancement is associated with an increase in the pharyngeal airway space (PAS) . Many of these studies have employed lateral cephalograms . To overcome two‐dimensional limitations, cone beam computed tomography (CBCT) has been used to obtain a three‐dimensional (3D) understanding of the resulting changes and quantification of the airway volume.…”

“…16,17 Many of these studies have employed lateral cephalograms. [18][19][20] To overcome two-dimensional limitations, cone beam computed tomography (CBCT) has been used [20][21][22] to obtain a three-dimensional (3D) understanding of the resulting changes and quantification of the airway volume. While recent studies have demonstrated airway changes resulting from mandibular advancement alone, the possible impact of simultaneous mandibular advancement with constriction has not been evaluated.…”

Role of Distraction Osteogenesis in the Management of Postankylotic Deformity

“…In children, it is established that TMJ ankylosis causes deficiency of growth of the mandible leading to facial asymmetry. 1,2 Duration of ankylosis and timing of its intervention for release is directly proportional to the severity in degree of facial asymmetry. Although simultaneous release and correction of deformity is being practised, but it is controversial.…”

“…Temporomandibular joint (TMJ) ankylosis is a common cause of acquired secondary deformities of mandible. In children, it is established that TMJ ankylosis causes deficiency of growth of the mandible leading to facial asymmetry 1,2. Duration of ankylosis and timing of its intervention for release is directly proportional to the severity in degree of facial asymmetry.…”