Changes in pharyngeal airway space and soft tissue after maxillary advancement and bimaxillary surgery

Abstract

Aim: To evaluate changes in pharyngeal airway space (nasopharynx and oropharynx), soft palate and lingual vallecula after maxillary advancement surgery and maxillary advancement and mandibular setback surgery (bimaxillary surgery). Methods: Twenty Class III adult patients were included in the study. Ten patients were treated with maxillary advancement and ten with bimaxillary surgery (maxillary advancement and mandibular setback). Cephalometric landmark measurements were recorded at 3 different time intervals: pre-surgical, post-surgical and six months after surgery. Data collected were subjected to one-way ANOVA (p<0.05). Results: Nasopharyngeal airway space increased after maxillary advancement and decreased after bimaxillary surgery. There was increase in oropharyngeal dimensions in the region around the uvula and loss of space for lingual vallecula, while in Group 2 there was diminished space for both uvula and vallecula. The uvula and vallecula were moved forward in Group 1, whereas these structures were moved in the posterior direction in Group 2. Conclusions: After maxillary advancement surgery there was an increased in space in the nasopharyngeal region. The oropharyngeal region related to the uvula presented an increase in space, whereas there was a reduction in relation to the lingual vallecula. The uvula and lingual vallecula were moved forward. Bimaxillary surgery promoted a reduction in the nasopharyngeal and oropharyngeal regions as regards both the uvula and lingual vallecula. The uvula and lingual vallecula were moved in the posterior direction.

Pharyngeal airspace in patients undergoing orthognathic surgery for mandibular advancement

“…Dentofacial deformities are congenital or growth malformations during the development which may cause functional and aesthetic problems [2][3] . Changes in the airways after orthognathic surgery have been the subject of great interest in recent years 1,4,8,13 .…”

“…Changes in facial skeleton produced by the surgery affect the bones of the facial skeleton and their relationship with soft tissues. An aspect to be considered is the impact of the skeleton movement on the pharyngeal airspace (PAS) of patients undergoing orthognathic surgery [1][2] .…”

“…In this context, it is observed that the movement of the facial skeleton produces changes in the tension of the soft tissues and muscles inserted in the jaw. Soft palate, tongue, hyoid bone and associated musculature are directly or indirectly inserted in the jaw, therefore movements in those structures induce alterations in the oral and nasal cavity and on the PAS [1][2][3][4][5] .…”