Changes in the pharyngeal airway after different orthognathic procedures for correction of class III dysplasia

Abstract

Objective This study was conducted to compare changes in pharyngeal airway after different orthognathic procedures in subjects with class III deformity. Methods The study included CBCT scans of 48 skeletal class III patients (29 females and 19 males, mean age 23.50 years) who underwent orthognathic surgery in conjunction with orthodontic treatment. The participants were divided into three groups of 16, as follows: Group 1, mandibular setback surgery; group 2, combined mandibular setback and maxillary advancement surgery; and group 3, maxillary advancement surgery. CBCT images were taken 1 day before surgery (T0), 1 day (T1), and 6 months (T2) later. The dimensions of the velopharynx, oropharynx, and hypopharynx were measured in CBCT images. Results In all groups, there was a significant decrease in airway variables immediately after surgery, with a significant reversal 6 months later (P < 0.05). In subjects who underwent maxillary advancement, the airway dimensions were significantly greater at T2 than the T0 time point (P < 0.05), whereas in the mandibular setback and bimaxillary surgery groups, the T2 values were lower than the baseline examination (P < 0.05). The alterations in airway variables were significantly different between the study groups (P < 0.05). Conclusions The mandibular setback procedure caused the greatest reduction in the pharyngeal airway, followed by the bimaxillary surgery and maxillary advancement groups, with the latter exhibiting an actual increase in the pharyngeal airway dimensions. It is recommended to prefer a two-jaw operation instead of a mandibular setback alone for correction of the prognathic mandible in subjects with predisposing factors to the development of sleep-disordered breathing.

Frontal Sinus Fractures: An Evaluation of Patient Demographics, Mechanisms of Injury, Classification, and Management Strategies in Patients Referred to a Trauma Center, From 2014 to 2019

“…Because of the limitations of 2-dimensional radiographs, CT scanning is now considered the gold standard for diagnosing and classifying frontal bone fractures. 9,29,30 The axial, coronal, and sagittal views were used in this study to detect any fracture in the anterior and posterior walls of the frontal sinus and orbital cavity and assess the patency of the nasofrontal duct. 24,31,32 The differentiation between anterior and posterior table fractures is vital for evaluating the risk of brain damage, estimating the prognosis, and selecting the correct treatment strategy.…”

“…In the present study, the diagnosis of frontal bone fracture was made through CT imaging scans, which were taken after anamnesis and clinical examinations. Because of the limitations of 2-dimensional radiographs, CT scanning is now considered the gold standard for diagnosing and classifying frontal bone fractures 9,29,30 . The axial, coronal, and sagittal views were used in this study to detect any fracture in the anterior and posterior walls of the frontal sinus and orbital cavity and assess the patency of the nasofrontal duct 24,31,32 …”

“…The information collected for each patient included age, sex, addictions, number of frontal sinuses, unilateral versus bilateral fracture, mechanism of injury (type of trauma), and classification of frontal sinus fracture. The age groups were defined as minors (0-17 y), young adults (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30), adults (31-60), and the elderly (above 60). The mechanism of injury involved a car accident, motorcycle accident, falling, physical assault, and other forms of trauma, such as sports and work-related injuries.…”

MSCT 3D Analysis of Nasopharyngeal Airway After Le Fort I Maxillary Setback Surgeries

“…The correlations between maxillary/mandibular advancement/ setback and pharyngeal airway had been widely reported in recent years. [15][16][17] However, comprehensive research about the impact of a maxillary setback on the nasopharynx is still vacant. Hence, our study focused on the impact of maxillary setback on nasopharynx and verified whether integral and segmental maxillary setbacks vary in terms of postoperative nasopharynx transformation.…”

“…The correlations between maxillary/mandibular advancement/setback and pharyngeal airway had been widely reported in recent years 15–17 . However, comprehensive research about the impact of a maxillary setback on the nasopharynx is still vacant.…”