Evaluation of pharyngeal airway space changes after bimaxillary orthognathic surgery with a 3-dimensional simulation and modeling program

Gökçe, Sıla Mermut; Görgülü, Serkan; Gökçe, Hasan; Bengi, Ali Osman; Karaçaylı, Ümit; Örs, Fatih

doi:10.1016/j.ajodo.2014.06.017

Cited by 67 publications

(53 citation statements)

References 38 publications

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“…Changes in the LTW, APL, and CSA were measured according to a method described using the Superimposition module of the Invivo 5 program. [7] Pre- and postoperative CBCT data were superimposed by point registration and automatic voxel-by-voxel registration at the unchanged craniomaxillofacial area by orthognathic surgery. On the superimposed images, LTW, APL, and CSA in the axial CV1, CV2, and CV3 were measured.…”

Section: Methodsmentioning

confidence: 99%

“…[5,6] Some authors have noted that narrowing of the posterior airway space (PAS) is expected after bimaxillary surgery. [7,8] As a consequence, patients who receive bimaxillary surgery might suffer from sleep-disordered breathing in particular, which is due to the narrowing of the PAS and airway collapse during sleep. [9–11] Sleep breathing disorders (SBDs) including obstructive sleep apnea (OSA) can be counted as a late complication of bimaxillary surgery.…”

Section: Introductionmentioning

confidence: 99%

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The structural changes of upper airway and newly developed sleep breathing disorders after surgical treatment in class III malocclusion subjects

Lee¹,

Oh²,

Min³

et al. 2017

Medicine

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Bimaxillary surgery is the traditional treatment of choice for correcting class III malocclusion which is reported to cause an alteration of oropharyngeal structures and upper airway narrowing that might be a predisposing factor for obstructive sleep apnea (OSA). This study aimed to analyze sleep parameters in class III malocclusion subjects and ascertain the prevalence of snoring or OSA following bimaxillary surgery.A total of 22 patients with Le Fort I osteotomy and mandibular setback for class III malocclusion were prospectively enrolled. All patients received endoscopic examination, cephalometry, 3-dimensional computed tomography (3D-CT), and sleep study twice at 1 month before and 3 months after surgery.The patient population consisted of 5 males and 17 females with a mean body mass index of 22.5 kg/m2 and mean age of 22.1 years. No patients complained of sleep-related symptoms, and the results of sleep study showed normal values before surgery. Three patients (13%) were newly diagnosed with mild or moderate OSA and 6 patients (27%) showed increased loudness of snoring (over 40 dB) after bimaxillary surgery. According to cephalometric analysis and 3D-CT results, the retropalatal and retroglossal areas were significantly narrowed in class III malocclusion patients, showing snoring and sleep apnea after surgery. In addition, the total volume of the upper airway was considerably reduced following surgery in the same patients.Postoperative narrowing of the upper airway and a reduction of total upper airway volume can be induced, and causes snoring and OSA in class III malocclusion subjects following bimaxillary surgery.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The structural changes of upper airway and newly developed sleep breathing disorders after surgical treatment in class III malocclusion subjects

Lee¹,

Oh²,

Min³

et al. 2017

Medicine

View full text Add to dashboard Cite

show abstract

“…Currently, in patients with Class-III deformities, only 10% of cases are treated by mandibular setback procedure alone; in 40% bimaxillary surgery is performed, and in 50% an isolated maxillary advancement is performed 11 . One factor that can explain this distribution is the impact of such procedures on the UA, as the mandibular setback promotes a decrease of airway space due to anteroposterior narrowing in the oropharynx and hypopharynx regions 12 and can result in an OSA 6,13,14 .…”

Section: Discussionmentioning

confidence: 99%

“…Although this method is useful for analysis in the sagittal plane, it has limitations, including overlapping of images and difficult delimitation between the structures, and it does not capture the airway width 11,13,15 . Computed tomography is one of the best methods for evaluating 3D structures of the UA and facial skeleton [15][16][17] .…”

Section: Discussionmentioning

confidence: 99%

“…Computed tomography is one of the best methods for evaluating 3D structures of the UA and facial skeleton [15][16][17] . Among its advantages is the evaluation of the regions in the coronal, axial, and sagittal planes; the visualization of soft and hard tissues; and the possibility of segmentation for volumetric analysis 8,[11][12][13] . However, image acquisition in both methods may be impaired due to the position of the head and tongue, breathing, and time necessary for the scanning procedure 8,18,19 .…”

Section: Discussionmentioning

confidence: 99%

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Volumetric and cephalometric evaluation of the upper airway of class III patients submitted to maxillary advancement

Santiago

Moura

Gabrielli

et al. 2016

Rev. odontol. UNESP

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ResumoIntrodução: A deficiência anteroposterior da maxila pode estar associada com a diminuição do volume da via aérea superior. O avanço de maxila por resultar em um aumento do espaço aéreo superior. Objetivo: Correlacionar mensurações cefalométricas (2D) e volumétricas (3D) da via aérea superior em pacientes classe III tratados por meio de avanço maxilar. Material e método: Este estudo retrospectivo transversal foi realizado em dez pacientes adultos submetidos ao avanço de maxila para correção de deficiência anteroposterior de maxila e deformidade classe III. Foram incluídos os dados de tomografias computadorizadas Cone beam em dois períodos: pré-operatório (T1) e pós-operatório de 6 a 8 meses (T2). Os arquivos DICOM foram importados e reconstruídos para avaliação volumétrica e cefalométrica da via aérea superior, dividida em nasofaringe, orofaringe e hipofaringe (Arnett & Gunson FAB Surgery). Resultado: A idade variou de 26 a 55 anos, com média de 36,3±9,2 anos. Não foram verificadas diferenças estatisticamente significantes para os parâmetros cefalométricos e volumétricos das três regiões da faringe entre os períodos T1 e T2. Este resultado ocorreu devido à pequena quantidade de avanço maxilar (4,7±1,89mm) necessário para a correção da deformidade na amostra. A correlação entre área e volume não foi estatisticamente significante apenas para as mensurações pré-operatórias da nasofaringe (r=0,30; p=0,40). Nas outras regiões e períodos a correlação foi estatisticamente significante (p<0,05). Conclusão: Avanços maxilares de pequenas dimensões não resultam em um aumento significativo das dimensões da via aérea superior.Descritores: Cirurgia ortognática; remodelação das vias aéreas; maxila. AbstractIntroduction: Anteroposterior maxillary deficiency can be associated with a decrease of upper airway volume. Maxillary advancement can improve the upper airway space. Aim: To correlate cephalometric (2D) and volumetric (3D) measurements of the upper airway in class III patients treated by maxillary advancement. Material and method: This retrospective transversal study was performed in ten adult patients submitted to maxillary advancement for correction of class III deformity secondary to maxillary anteroposterior deficiency. The Cone beam tomography files included in the medical records were used: (T1) pre-operative and (T2) 6 to 8 months postoperative. The DICOM files were imported and reconstructed for volumetric and cephalometric evaluation of the upper airway, as divided into nasopharynx, oropharynx and hypopharynx (Arnett & Gunson FAB Surgery). Result: Age ranged from 26 to 55 years with a mean of 36.3±9.2 years. There were no statistically significant differences for cephalometric and volumetric parameters of the three pharyngeal regions between T1 and T2 periods. This was due to the small amount of maxillary advancement necessary to correct the maxillary deformity in the studied patients (4.7±1.89mm). The correlation between area and volume was not statistically significant only for preoperative measurements of t...

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Maxillomandibular Advancement for Treatment of Obstructive Sleep Apnea

Zaghi

Holty

Certal

et al. 2016

JAMA Otolaryngol Head Neck Surg

294

190

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Evaluation of pharyngeal airway space changes after bimaxillary orthognathic surgery with a 3-dimensional simulation and modeling program

Cited by 67 publications

References 38 publications

The structural changes of upper airway and newly developed sleep breathing disorders after surgical treatment in class III malocclusion subjects

The structural changes of upper airway and newly developed sleep breathing disorders after surgical treatment in class III malocclusion subjects

Volumetric and cephalometric evaluation of the upper airway of class III patients submitted to maxillary advancement

Maxillomandibular Advancement for Treatment of Obstructive Sleep Apnea

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