Pharyngeal airway evaluation following isolated surgical mandibular advancement: A 1-year follow-up

Kochar, Gagan Deep; Sharma, Mohit; Chowdhury, Souma; Londhe, SM; Kumar, Peri Harish; Jain, Amit; Waingankar, Akshay Madhukar

doi:10.1016/j.ajodo.2018.03.023

Cited by 7 publications

(8 citation statements)

References 27 publications

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“…One study 46 reported significant increase of minimum and mean cross‐sectional area and total volume of the upper airways, measured on acoustic pharyngometry, 2 months after surgery; all the variables observed some relapse within 1‐year of follow‐up after SMA.…”

Section: Resultsmentioning

confidence: 99%

“…Twenty papers were finally included in the SR 32‐51 . The data extracted from the included papers are reported in Table 2.…”

Section: Resultsmentioning

confidence: 99%

“…Most of the included papers adopted cephalometric tracings to evaluate the upper airway dimensions, while only four studies 33,35,38,49 used CT/CBCT and one study adopted acoustic pharyngometry, 46 offering a three-dimensional assessment of the anatomical structures. Lateral cephalogram has been for long time the gold standard imaging technique for the evaluation of the airway space, since bi-dimensional measurements of the airways passage were reliable and reproducible, 58 and significant correlation between the airway space measured on cephalograms and the volume of the airway calculated from the three-dimensional studies was demonstrated.…”

Section: Discussionmentioning

confidence: 99%

“…Twenty papers were finally included in the SR. [32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51] The data extracted from the included papers are reported in Table 2. The number of subjects included in the studies ranged from 15 to 102, with a total number of 617 Class II adult individuals treated with SMA.…”

Section: Study Selectionmentioning

confidence: 99%

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Effects of surgical mandibular advancement on the upper airways of adult class II patients: A systematic review with meta‐analysis

Bucci

Rongo

Bucci

et al. 2021

J of Oral Rehabilitation

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Aim To systematically review the effects of surgical mandibular advancement (SMA) regarding changes of the upper airways in adult patients with skeletal Class II malocclusion. Materials and Methods Five electronic databases were searched up to April 2020. Human studies focusing on the morphology and dimension of the upper airways after SMA were included. ‘Quality assessment for Before‐After (Pre‐Post) Studies’ was used to assess the risk of bias of the individual studies. Standard mean differences (SMD) with 95% confidence intervals (CI) were calculated for random effect model meta‐analysis. The certainty of evidence was assessed using the GRADE tool. Results Twenty cohort studies of only treated patients without control group were eligible for qualitative synthesis, of which 17 were used for quantitative synthesis. Very low certainty of evidence indicated that SMA resulted in significant increase of the volume and of the smallest cross‐sectional area (SMC) of the nasopharynx (volume SMD: 1.43, CI: 0.62, 2.24, P = .001, I2 = 87.8%; SMC SMD: 1.53, CI: 0.59, 2.47, P = .001, I2 = 90.5%) and oropharynx (volume SMD: 1.36, CI: 0.37,2.35, P = .007, I2 = 92.1%; SMC SMD: 1.21, CI: 0.11,2.32, P = .032, I2 = 93.1%). Significant augmentation of the distances between the posterior pharynx wall and the uvala (SMD: 0.73, CI: 0.46,0.98, P < .001, I2 = 72.7%), the posterior border of the tongue (SMD: 0.52, CI: 0.21,0.84, P = .001; I2: 60.5%), the gonion (SMD: 1.24, CI: 0.56,1.91, P < .001; I2 = 88.8%) and the epiglottis (SMD: 0.40, CI: 0.06,0.74, P = .033; I2 = 84.8%) were observed. Conclusions Weak evidence suggests enlargement of the upper airways of adult Class II subjects following SMA, with major increases in the oropharynx.

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Section: Resultsmentioning

confidence: 99%

“…Twenty papers were finally included in the SR 32‐51 . The data extracted from the included papers are reported in Table 2.…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

See 2 more Smart Citations

Effects of surgical mandibular advancement on the upper airways of adult class II patients: A systematic review with meta‐analysis

Bucci

Rongo

Bucci

et al. 2021

J of Oral Rehabilitation

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“…Relapse was also observed 1 year after surgery of the previous airway measurements 12.6% , 7.9% and 3.9% respectively. 52 Airway Changes with Subgroups (Age, Gender, GTA procedure)…”

Section: Correlation Of Amount Of Skeletal Relapse and Oropharyngeal mentioning

confidence: 99%

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 Surgery: Effects on Voice and Wind Instrument Performance

Hamdan

2021

Dentofacial Anomalies

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Pharyngeal airway evaluation following isolated surgical mandibular advancement: A 1-year follow-up

Cited by 7 publications

References 27 publications

Effects of surgical mandibular advancement on the upper airways of adult class II patients: A systematic review with meta‐analysis

Effects of surgical mandibular advancement on the upper airways of adult class II patients: A systematic review with meta‐analysis

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

Orthognathic Surgery: Effects on Voice and Wind Instrument Performance

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