Effects of mandibular advancement surgery combined with minimal maxillary displacement on the volume and most restricted cross-sectional area of the pharyngeal airway

Valladares‐Neto, José; Silva, M.A.G.; Bumann, Axel; Paiva, João Batista de; Rino-Neto, José

doi:10.1016/j.ijom.2013.03.018

Cited by 25 publications

(9 citation statements)

References 28 publications

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“…Although Rosario et al [ 3 ]did not report any suspicion on this matter and have included both studies in their meta-analysis, only one[ 42 ] of the articles has been included for the meta-analysis in this overview to avoid potential duplication. Besides, another primary study[ 44 ] meta-analyzed by Rosario et al [ 3 ] was not included in this meta-analysis performed here because the maxillary procedures of that study comprised of those with or without advancement movement. On the other hand, two primary studies[ 45 , 46 ] included but not meta-analyzed by Christovam et al [ 11 ] were found eligible to be included in the meta-analysis of this meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

How does mandibular advancement with or without maxillary procedures affect pharyngeal airways? An overview of systematic reviews

et al. 2017

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BackgroundMandibular advancement surgery may positively affect pharyngeal airways and therefore potentially beneficial to obstructive sleep apnea (OSA).ObjectiveTo collect evidence from published systematic reviews that have evaluated pharyngeal airway changes related to mandibular advancement with or without maxillary procedures.MethodologyPubMed, EMBASE, Web of Science, and Cochrane Library were searched without limiting language or timeline. Eligible systematic reviews evaluating changes in pharyngeal airway dimensions and respiratory parameters after mandibular advancement with or without maxillary surgery were identified and included.ResultsThis overview has included eleven systematic reviews. Maxillomandibular advancement (MMA) increases linear, cross-sectional plane and volumetric measurements of pharyngeal airways significantly (p<0.0001), while reducing the apnea-hypopnea index (AHI) and the respiratory disturbance index (RDI) significantly (p<0.0001). Two systematic reviews included primary studies that have evaluated single-jaw mandibular advancement, but did not discuss their effect onto pharyngeal airways. Based on the included primary studies of those systematic reviews, single-jaw mandibular advancement was reported to significantly increase pharyngeal airway dimensions (p<0.05); however, conclusive long-term results were lacking.ConclusionMMA increases pharyngeal airway dimensions and is beneficial to patients suffering from OSA. However, more evidence is still needed to draw definite conclusion related to the effect of single-jaw mandibular advancement osteotomies on pharyngeal airways.

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Section: Resultsmentioning

confidence: 99%

How does mandibular advancement with or without maxillary procedures affect pharyngeal airways? An overview of systematic reviews

et al. 2017

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“…The position of head and tongue posture has been mentioned to have a big influence on the upper airway dimension in many studies and it has been warned that bias may evolve as a result of lack of a standardized head and tongue posture at the time of image acquisition [ 4 , 8 , 18 , 25-27 , 40-42 ]. A standardized acquisition posture was hence searched for.…”

Section: Discussionmentioning

confidence: 99%

Effect of Head and Tongue Posture on the Pharyngeal Airway Dimensions and Morphology in Three-Dimensional Imaging: a Systematic Review

Gurani

Carlo

Cattaneo

et al. 2016

JOMR

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ObjectivesNatural head position is recommended to be optimal at cone-beam computed tomography acquisition. For standardization purposes in control of treatment outcome, it is clinically relevant to discuss, if a change of posture from natural head position may have an effect on the pharyngeal airway dimensions and morphology, during computed tomography, cone-beam computed tomography or magnetic resonance imaging acquisition. This was the aim of the present literature review study for purposes of valid evidence, which was hypothesized, to be present.Material and MethodsThis systematic literature review has been registered in PROSPERO database with following number: CRD42015024567. A systematic literature search performed in PubMed, Embase and Cochrane was carried out in order to evaluate if the effect of human head or tongue posture has an effect on upper airway dimensions and morphology in CT, CBCT or MRI. Study quality assessment was performed. Predictor variable was head and tongue posture. Endpoints were numerical values of upper airway dimensions and morphology.ResultsOverall 1344 articles (Embase 1063, PubMed 269, and Cochrane 12) resulted in four included publications. Quality assessments revealed poor quality and low-level evidence by 46 - 67% of the maximum achievable score. Heterogeneous methodology made a meta-analysis impossible, consequently a narrative synthesis was performed.ConclusionsLimited, poor quality and low evidence level literature is available on the effect of head posture on upper airway dimensions and morphology in three-dimensional imaging. Valid evidence requires a standardized method of head and tongue posture during image acquisition in future studies.

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“…In the OSA patient, pharyngeal obstruction mostly occurs in the oropharynx [21]. Measuring changes in the most constricted area (minimal cross section), because of collapsibility of the pharynx is regarded as the best parameter to measure treatment outcomes [22]. Prior to the introduction of cone beam computed tomography (CBCT), very little information could be obtained from the use of conventional imaging studies, such as lateral cephalometric radiographs to evaluate treatment of the OSA patient [23].…”

Section: Obstructive Sleep Apnea and Cone Beam Computed Tomography (Cbct)mentioning

confidence: 99%

Evaluation of a non-ablative Er: YAG laser procedure to increase the oropharyngeal airway volume: A pilot study

Lee¹,

Lee²

2015

Dent Oral Craniofac Res

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Background: Sleep disordered breathing, specifically obstructive sleep apnea (OSA) is due to constriction of the oropharyngeal airway during sleep and has major public health implications. By conservative estimates, 3% of the adult population are suffering from OSA characterized by sleep deprivation, fatigue during the day and somnolence. The most common treatment for sleep apnea is continuous positive airway pressure (CPAP). However, CPAP does not eliminate the cause of OSA. Methods:The goal of this prospective pilot study was to evaluate the changes of the total airway volume and most constricted area of the oropharyngeal airway using a non-ablative laser procedure. Cone beam computed tomography (CBCT) scans were obtained from seven patients enrolled in the study. Airway volume measurements were calculated before and after laser treatment using 3D volumetric software. Results:The photothermic effects of a non-ablative laser procedure increased the mean total airway volume from 10.23 ± 0.94 mL to 12.54 ± 1.01 mL (p=0.0179), and the minimum cross-sectional area from 109.7 ± 20.6 mm 2 to 142.4 ± 29.2 mm 2 (p=0.0484) approximately 12 weeks post-laser treatment.Conclusions: Non-ablative laser therapy may be a promising non-surgical treatment modality for increasing the oropharyngeal airway volume, especially the most constricted area. Clinical implications:The results of this pilot study demonstrate that photothermal energy applied to the pharyngeal and palatal soft tissues may prove to be beneficial in the non-surgical management of sleep disordered breathing, especially the CPAP intolerant individual.

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Effects of mandibular advancement surgery combined with minimal maxillary displacement on the volume and most restricted cross-sectional area of the pharyngeal airway

Cited by 25 publications

References 28 publications

How does mandibular advancement with or without maxillary procedures affect pharyngeal airways? An overview of systematic reviews

How does mandibular advancement with or without maxillary procedures affect pharyngeal airways? An overview of systematic reviews

Effect of Head and Tongue Posture on the Pharyngeal Airway Dimensions and Morphology in Three-Dimensional Imaging: a Systematic Review

Evaluation of a non-ablative Er: YAG laser procedure to increase the oropharyngeal airway volume: A pilot study

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