Computational fluid dynamics study of the pharyngeal airway space before and after mandibular setback surgery in patients with mandibular prognathism

Yajima, Yasuharu; Oshima, Mitsuko; Iwai, Toshinori; Kitajima, Hiroaki; Omura, Susumu; Tohnai, Iwai

doi:10.1016/j.ijom.2017.03.028

Cited by 30 publications

(41 citation statements)

References 37 publications

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“…To apply CFD simulation to such a "flabby" organ, it was reconstructed into a simple shape. CFD simulation applied to the reconstructed airway was helpful in effectively analyzing the airflow pattern according to the individual patient's airway type [10,11,25,27,28].…”

Section: Discussionmentioning

confidence: 99%

“…CFD simulation applied to the reconstructed airway was helpful in effectively analyzing the airflow pattern according to the individual patient's airway type. [10,11,25,27,28] Analysis revealed that the velopharynx at T1 was narrowed, but the oropharynx was rather widened. This is assumed to be a result of the upward movement of the maxillomandibular complex because the position of the hyoid bone did not change immediately after the operation, and the distance from the mandible was increased.…”

Section: Discussionmentioning

confidence: 99%

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Application of Computational Fluid Dynamics Analysis after Bimaxillary Orthognathic Surgery

et al. 2020

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Bimaxillary orthognathic surgery is widely used to treat skeletal class III malocclusion. Changes in jaw position affect the shape of surrounding soft tissues. We used computational fluid dynamics (CFD) simulation to observe changes in airways observed in a patient who underwent bimaxillary orthognathic surgery. For CFD simulation, we performed cone beam computed tomography (CBCT) preoperatively (T0), 3 days postoperatively (T1), and 7 months postoperatively (T2). The values of velocity, pressure drop (ΔP), and wall shear stress all increased 7 months after surgery (Vmax 7.038 m/s to 12.054 m/s, ΔP −7.723 Pa to −53.739 Pa, WSSmax 4.214 Pa to 14.323 Pa). Locations where the velocity and pressure gradients are large included the velopharynx, oropharynx, and epiglottis, with narrow cross-sectional areas. Wall shear stress was also observed at these locations. The velopharynx, oropharynx, and epiglottis are structures most vulnerable to morphological changes, that is, they can easily become obstructed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Application of Computational Fluid Dynamics Analysis after Bimaxillary Orthognathic Surgery

et al. 2020

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“…Recent systemic review has concluded that there is no clear association between mandibular setback surgery and occurrence of obstructive sleep apnea (OSA) [ 6 ]. Other studies have shown that bimaxillary orthognathic surgery is less likely to induce airway obstruction or OSA compared to mandibular setback surgery as a standalone procedure [ 7 – 10 ]. However, multilevel compensative change of airway space related following bimaxillary orthognathic surgery with maxillomandibular setback is unclear.…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional analysis of changes in airway space after bimaxillary orthognathic surgery with maxillomandibular setback and their association with obstructive sleep apnea

Jang

Ahn

Paeng

et al. 2018

Maxillofac Plast Reconstr Surg

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BackgroundBimaxillary orthognathic surgery with maxillomandibular setback is often accompanied by changes in airway space. We analyzed the changes in airway space before and after surgery and assessed their association with obstructive sleep apnea.MethodsThis study is based on the cohort of 13 adult patients (9 males, 4 females, average age 23.85 years) who underwent bimaxillary orthognathic surgery with maxillomandibular setback.We performed computed tomography and portable polysomnography before and after the surgery to assess changes in airway space and Apnea-Hypopnea Index (AHI) values (total, supine, non-supine).ResultsThe oropharyngeal airway volume decreased by 29% after the surgery, which was statistically significant (p < .05). The upper airway volume and hypopharyngeal airway volume were decreased, but not significantly (4 and 19%, respectively). The changes in airway surface area were statistically significant at all levels examined (p < .05). Changes in the maximum anteroposterior width of the airway were also significant at all levels (p < .05). However, the changes in maximum lateral width were only statistically significant at C2 level (p < .05). AHI values were increased after the surgery but not significantly at any position.ConclusionsAlthough bimaxillary surgery with maxillomandibular setback significantly reduces the airway space, it does not affect AHI values or induce obstructive sleep apnea.

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“…Com o avanço da tecnologia, estas avaliações foram sendo realizadas pela imagem tridimensional com a tomografia computadorizada de feixe cônico. Além disso, alguns autores passaram a utilizar a rinomanometria, rinometria acústica, a nasofaringoscopia e a dinâmica computacional de fluídos como uma avaliação mais objetiva das variações da permeabilidade nasal em resposta à cirurgia ortognática (CHEN et al, 2005;GUIJARRO-MARTÍNEZ;SWENNEN, 2011;LEE et al, 2012;PIMENTA et al, 2015;VIDOTTI;TRINDADE, 2008;YAJIMA et al, 2017).…”

Section: Tipo De Fissuraunclassified

“…Buscou-se, então, a utilização de métodos que permitissem uma avaliação mais objetiva da via aérea. (CHEN et al, 2005;VIDOTTI;TRINDADE, 2008;GUIJARRO-MARTÍNEZ;SWENNEN, 2011;LEE et al, 2012;PIMENTA et al, 2015;YAJIMA et al, 2017).…”

Section: Introductionunclassified

Avaliação das dimensões da nasofaringe através da tomografia computadorizada e pela rinomanometria anterior modificada em indivíduos com fissura labiopalatina submetidos à cirurgia ortognática

Medeiros¹

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Leide Fidelis e a todos os pós-graduandos do laboratório de Fisiologia do Hospital de Reabilitação e Anomalias Craniofaciais-HRAC/USP, pela ajuda na elaboração deste estudo. À professora e querida amiga, Dra. Ivy Trindade, pela ajuda na execução deste trabalho. Obrigada por ter sido minha primeira orientadora na vida acadêmica, pela paciência, dedicação e carinho. Ao Dr. Yifan Guo e Dr. Luis Sensi, por me receberem tão bem na Medical School e Dental School da East Carolina University-USA, além de todo conhecimento compartilhado e pela experiência única que tive no mestrado. À todos os professores e mestres que fizeram parte da minha trajetória acadêmica. Em especial a professora Bella Colombini Ishikiriama, pelos conselhos e ensinamentos passados.

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Computational fluid dynamics study of the pharyngeal airway space before and after mandibular setback surgery in patients with mandibular prognathism

Cited by 30 publications

References 37 publications

Application of Computational Fluid Dynamics Analysis after Bimaxillary Orthognathic Surgery

Application of Computational Fluid Dynamics Analysis after Bimaxillary Orthognathic Surgery

Three-dimensional analysis of changes in airway space after bimaxillary orthognathic surgery with maxillomandibular setback and their association with obstructive sleep apnea

Avaliação das dimensões da nasofaringe através da tomografia computadorizada e pela rinomanometria anterior modificada em indivíduos com fissura labiopalatina submetidos à cirurgia ortognática

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