Predictive Soft Tissue Airway Volume Analysis in Mandibular Distraction

Abstract

Three-dimensional computed tomography has been used in both preoperative planning of mandibular distraction osteogenesis and in the evaluation of postoperative resolution of tongue-based airway obstruction. The authors present a case report using software to predict postdistraction airway volume during virtual surgical planning (VSP) of mandibular distraction osteogenesis in a 7 year old. The predicted increase in airway volume derived from VSP was 33.57% (1716 mm(3) preoperatively to 2292 mm(3) postvirtual distraction). Based on the three-dimensional computed tomography, the actual airway volume increased to 2211 mm(3) postoperatively, a 28.85% increase.The implications of this advancing technology are far-reaching. An illustrative case is presented herein to demonstrate the efficacy of the airway prediction and its limitations. The authors believe that, with continued investigation, this novel approach may be a standard feature of all VSP sessions for the treatment of tongue-based airway obstruction.

Airway Morphological Changes in Pierre Robin Sequence: A Retrospective Study

“…Virtual surgical planning was utilized preoperatively using the 3-D-reformatted CT data. Mandibular distraction end point was based on predicted skeletal advancement of the mandible and airway volume after the virtual surgery (Mhlaba et al, 2016). Standard protocol for all patients included a latency period of 24 hours followed by distractor activation at 1 to 1.5 mm/d (0.5 mm twice daily [BID] or 1 mm am /0.5 mm pm ) for 2 to 5 days followed by 1 mm/d (0.5 mm BID) until the virtual distraction end point was reached.…”

Creating Normative Growth Curves for Pediatric Upper Airway Volume

“…25 3D reconstructions are obtained and volumetric analysis of the upper airway is performed and frequently used in preoperative planning. 14,16,26 Previous studies have demonstrated that mandibular distraction is effective in expanding the upper airway. 10,[27][28][29] However, predicting how much expansion is necessary to affect a physiologic response is challenging, 16 and an arbitrary percentage of volume increase is often used to determine the approximate length of mandibular advancement.…”

Virtual Planning and 3D Printing in Contemporary Orthognathic Surgery

“…Second, an understated feature of VSP is the ability to simulate soft tissue changes that occur from virtual surgery, including external soft-tissue elements such as facial contours and airway simulation. 51 52 Though some limitations in VSP software exist in terms of soft-tissue modeling, the ability to compare simulated and postoperative airway volumes and external soft tissue drape can be used as a modicum of quality control.…”