Computed tomography visualizing alterations in the upper airway after orthognathic surgery

Alcalde, Luis Fernando Azambuja; Faria, Paulo Esteves Pinto; Nogueira, Renato Luiz Maia; Chihara, Letícia Liana; Sant’Ana, Eduardo

doi:10.1016/j.jcms.2019.04.006

Cited by 11 publications

(5 citation statements)

References 17 publications

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“…In our study 3-D CBCT were used for evaluate the changes of the airway in agreement with the previous authors (15,(19)(20)(21) who utilized CBCT to evaluate the airway volumetric and dimensional changes. They found that CBCT imaging technique provided more accurate measurements with lower radiation dose and lower cost than those of other techniques.…”

Section: Discussionsupporting

confidence: 80%

“…(1,4,12) Some have evaluated the improvement in overall volume in response to single-jaw or bimaxillary progression surgery. (14)(15)(16) Several studies in the literature have reported the airway changes after orthognathic surgery however, to our knowledge there was no reports on its effect in Egyptian population.…”

Section: Introductionmentioning

confidence: 97%

“…(2,(9)(10)(11)(12) the effects of orthognathic surgeries on the airway have been studied by several authors. (13)(14)(15)(16)(17) many have attempted to determine the impact of bimaxillary progression or single mandibular advancement on various upper airway compartments. (1,4,12) Some have evaluated the improvement in overall volume in response to single-jaw or bimaxillary progression surgery.…”

Section: Introductionmentioning

confidence: 99%

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Three-Dimensional Evaluation Of The Oropharyngeal Airway Changes After Bimaxillary Orthognathic Surgery Using Cone-Beam Computer Tomography: A Retrospective Analysis

Shehab

Sorour

Monim

2021

Egyptian Dental Journal

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Objectives:The purpose of this study was to assess and compare the volumetric, cross sectional surface area, and linear changes of the oropharyngeal airway in patients following bimaxillary orthognathic surgery using 3-D cone beam computer tomography (CBCT) imaging. Material and Methods:A total thirty patients have been included in the study. Fifteen patients underwent maxillary and mandibular advancements (Group A), while the other fifteen patients underwent maxillary advancement and mandibular setback (Group B). Volume changes in airways, surface area, and linear values from specified hard and soft tissue parameters have been reported.Results: Statistical analysis comparing the results of the two groups showed that Group A was statistically significantly higher mean % increase than Group B in volumetric, surface area and linear measurements. Both groups failed to show a statistically significant change in surface area post-operatively. Group B showed no statistically significant change in linear measurements at any levels. Conclusion:Significant changes in the measured parameters was observed in patients performing maxillary and mandibular advancement thus increasing the airway volume; which can provide surgeons with a greater confidence that this combination movement is not altering the airway in a negative way.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Three-Dimensional Evaluation Of The Oropharyngeal Airway Changes After Bimaxillary Orthognathic Surgery Using Cone-Beam Computer Tomography: A Retrospective Analysis

Shehab

Sorour

Monim

2021

Egyptian Dental Journal

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“…The present study findings indicate that anatomic craniofacial factors may influence OSA severity, MAD outcomes, and the amount of protrusion for resolutive mandibular advancement therapy. Such results grant better knowledge to use MAD as a possible treatment option while also considering the indication for consolidated and predictable surgical therapies [41,56,57]. Importantly, the findings of this study highlight clinical decisions considering individual characteristics, prognosis, and interests.…”

Section: Discussionmentioning

confidence: 62%

Three-dimensional craniofacial characteristics associated with obstructive sleep apnea severity and treatment outcomes

et al. 2021

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Objectives This study aims to assess craniofacial dimensions in obstructive sleep apnea (OSA) patients treated with a mandibular advancement device (MAD) and to identify anatomic influences on OSA severity and MAD therapy outcomes. Materials and methods Twenty patients with OSA were prospectively treated with MAD. Clinical, cone-beam computed tomography, and polysomnography exams were performed before treatment and 4-6 months after achieving the MAD therapeutic position. Polysomnographic exams and three-dimensional maxillary, mandibular, and upper airway (UA) measurements were evaluated. Pearson's correlation and t-tests were applied. Results Before MAD treatment, the transverse width measured at the frontomaxillary suture and the angle between the mandibular ramus and Frankfurt horizontal were statistically correlated with apnea and the hypopnea index (AHI), while the gonial angle was correlated with therapeutic protrusion. After MAD treatment, all patients showed a significant AHI reduction and an improvement in minimum oxyhemoglobin saturation. The UA total volume, superior and inferior oropharynx volume, and area were statistically correlated with MAD therapeutic protrusion. The UA total area showed a statistical correlation with the improvement in AHI, and the superior oropharynx volume and area increased significantly. Conclusions The transversal frontomaxillary suture width and the mandibular ramus facial angle may influence OSA severity. The gonial angle, volume, and area of all UA regions may indicate the amount of protrusion needed for successful MAD treatment. Clinical relevanceThe craniofacial characteristics reported as important factors for OSA severity and MAD treatment outcomes impact therapy planning for OSA patients, considering individual anatomic characteristics, prognosis, and cost benefits.

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“…Orthodontic-orthognathic treatment changes the position of the jaws and affects the shape of the upper airway to some extent. A previous report demonstrated that bimaxillary setback significantly decreased the volume and minimum axial area of the upper airway [ 5 ]. In addition, studies have shown that the minimum airway cross-sectional area is associated with the development of obstructive sleep apnea (OSA) [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Quantification of pharyngeal airway space changes after two-jaw orthognathic surgery in skeletal class III patients

Zhang

Wang

et al. 2023

BMC Oral Health

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Background Skeletal class III malocclusion is a common dentofacial deformity. Orthognathic treatment changes the position of the jaws and affects the shape of the upper airway to some extent. The aim of this study was to use multislice spiral computer tomography data and orthognathic knowledge to quantify the relationship between the amount of surgical movement of the maxilla or mandible in all three spatial planes and the changes in airway volume that occurred. Methods A retrospective study of 50 patients was conducted. Preoperative and postoperative linear changes related to skeletal movements of the maxilla and mandible were measured and compared to changes in the most constricted axial level (MCA) and its anteroposterior (MCA-AP) and transverse diameters (MCA-TV). Correlation tests and linear regression analysis were performed. Results Significant interactions were observed between the anterior vertical movement of the maxilla and the MCA-AP. The anteroposterior movement distance of the mandible was significantly correlated with changes in the oropharyngeal, velopharyngeal, total airway volume, MCA, MCA-AP, and MCA-TV. The change in the mandibular plane angle was significantly correlated with the change in velopharyngeal volume, total airway volume (nasopharynx, oropharynx, velopharynx), and MCA. The linear regression model showed that oropharyngeal volume decreased by 350.04 mm3, velopharyngeal volume decreased by 311.50 mm3, total airway volume decreased by 790.46 mm3, MCA decreased by 10.96 mm2 and MCA-AP decreased by 0.73 mm2 when point B was setback by 1 mm. Conclusions Anteroposterior mandibular control is the key to successful airway management in all patients. This study provides estimates of volume change per millimeter of setback to guide surgeons in treatment planning.

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Computed tomography visualizing alterations in the upper airway after orthognathic surgery

Cited by 11 publications

References 17 publications

Three-Dimensional Evaluation Of The Oropharyngeal Airway Changes After Bimaxillary Orthognathic Surgery Using Cone-Beam Computer Tomography: A Retrospective Analysis

Three-Dimensional Evaluation Of The Oropharyngeal Airway Changes After Bimaxillary Orthognathic Surgery Using Cone-Beam Computer Tomography: A Retrospective Analysis

Three-dimensional craniofacial characteristics associated with obstructive sleep apnea severity and treatment outcomes

Quantification of pharyngeal airway space changes after two-jaw orthognathic surgery in skeletal class III patients

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