The influence of orthognathic surgery on ventilation during sleep

Foltán, René; Hoffmannová, J.; Pavlíková, Gabriela; Hanzelka, T.; Klíma, Karel; Horká, Edita; Adámek, S; Šedý, Jiří

doi:10.1016/j.ijom.2010.10.006

Cited by 60 publications

(42 citation statements)

References 18 publications

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“…This agrees with Paoli et al [37] who mentioned that the risk of development of obstructive sleep apnea should be included as a parameter for indication of mandibular setback, and with Ramesh et al [38] who observed considerable reduction of the airway space in all patients, predisposing them to obstructive sleep apnea. Considering our results and accordingly with others authors [39][40][41][42], anteroposterior discrepancies may be corrected by combined maxillomandibular osteotomies, when this does not impair the aesthetic result of the procedure. Thus, it may be concluded that maxillomandibular orthognathic surgery for correction of mandibular prognathism did not statistically significantly change the upper (nasopharynx), middle (oropharynx) and lower (hypopharynx) pharyngeal airway spaces.…”

Section: Discussionsupporting

confidence: 89%

Computerized Cephalometric Study of the Pharyngeal Airway Space in Patients Submitted to Orthognathic Surgery

Gonçales

Rocha

Gonçales

et al. 2013

J. Maxillofac. Oral Surg.

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Introduction Pharynx is a muscular organ with is sustained by craniofacial bones. It is divided into nasal, oral and hipopharynx, and can be considered as a tube that serves both respiratory and digestive systems. Its anatomical morphology permits that factors facilitate its obstruction, leading to the sleep apnea syndrome. One of the treatment consists of surgical mandibular advancement, increasing pharyngeal dimensions. The aim of this study was evaluate the cephalometric changes in the pharyngeal airway space after orthognathic surgery procedures for correction of mandibular prognathism. Materials and Methods Pre and post-operative cephalometric analysis was performed on 19 patients submitted to mandibular setback by mandibular bilateral sagittal split osteotomy associated with maxillary advancement by Le Fort I osteotomy, using the Dolphin Imaging 10.0 software. Results Results did not reveal statistically significant changes in the upper (nasopharyngeal), middle (oropharyngeal) and lower (hypopharyngeal) airway spaces, but showed increase in the nasal pharynx due the maxillary advancement and a lower position of the hyoid bone due the mandibular setback.Discussion Maxillomandibular orthognathic surgery for correction of mandibular prognathism does not seem to statistically significantly change the pharyngeal airway space, but it increases the maxillary airway. Conclusion It seems to be important to consider the double jaw surgery in cases of mandibular prognathism, aiming prevention of a possible reduction of whole upper airway.

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Section: Discussionsupporting

confidence: 89%

Computerized Cephalometric Study of the Pharyngeal Airway Space in Patients Submitted to Orthognathic Surgery

Gonçales

Rocha

Gonçales

et al. 2013

J. Maxillofac. Oral Surg.

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“…As a result of the vasodilator effect, manifested as increased CBV and CBF, the blood and oxygen supply to the brain is also increased, which might make children with NE sleep less ''deeply.'' According to Foltán et al, 31 the respiratory disturbance index and obstructive apneas of patients during sleep improved significantly when treated with surgically assisted RME. In a recent study, Schütz et al 32 analyzed, through polysomnography, the nocturnal breathing of 16 adolescents who underwent maxillary expansion and mandibular advancement with a Herbst appliance.…”

Section: Discussionmentioning

confidence: 96%

“…The number of respiratory effortrelated arousals and the respiratory disturbance index decreased after treatment. Foltá n et al 31 and Schütz et al 32 attributed these changes to an increased nasal volume. But according to Deeb et al, 33 Langer et al, 34 and Giuca et al, 35 there was no significant correlation between the increase in nasal volume and transverse expansion.…”

Section: Discussionmentioning

confidence: 99%

Changes in CT cerebral blood flow and volume associated with rapid maxillary expansion in a rabbit model

Wang

Zhang

et al. 2012

The Angle Orthodontist

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Objective: To evaluate hemodynamic changes of the brain under the high forces of a rapid maxillary expansion (RME) appliance in a rabbit model. Materials and Methods: Twenty-four male New Zealand white rabbits were selected (12 weeks old, mean weight 3.01 6 0.22 kg). A modified acrylic resin bonded RME appliance was used for expansion. A series of perfusion computed tomography examinations was performed before expansion (T0), on the fifth day of expansion (T1), at the end of the expansion process (T2), and after 10 days of retention (T3). Cerebral blood flow, cerebral blood volume, and mean transit time maps were recorded and parametrics evaluated. Statistical analyses were performed with analysis of variance with post hoc tests. Results: Mean cerebral blood flow showed an increase from T0 to T2 and then a decrease from T2 to T3, but the change was not statistically significant. Mean cerebral blood volume and mean transit time increased significantly from T0 to T2, and all perfusion parameters increased from T0 to T3. Conclusions: RME is a safe orthopedic method despite the high expansion force. Perfusion computed tomography is effective for evaluating the hemodynamic changes of the brain caused by some orthopedic therapies. The increase in both cerebral blood volume and cerebral blood flow may help to explain why RME could alleviate the symptoms of enuretic children. (Angle Orthod. 2012;82:418-423.)

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“…This surgical process consists essentially of a series of osteotomies to reposition all the displaced parts of the jaw to achieve an ideal static and dynamical dental occlusion and facial symmetry [1,2]. Besides the obvious functional and esthetical gain, which impacts directly on quality of life and self-esteem, the benefits of orthognathic surgery are wide, providing effects on the speech, chewing, smile and patient respiratory parameters, such as oxygen saturation [3].…”

Section: Introductionmentioning

confidence: 99%