Pharyngeal airway evaluation after isolated mandibular setback surgery using cone-beam computed tomography

Irani, Shireen K.; Oliver, Dana; Movahed, Reza; Kim, Yong Il; Thiesen, Guilherme; Kim, Ki Beom

doi:10.1016/j.ajodo.2017.05.031

Cited by 33 publications

(24 citation statements)

References 31 publications

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“…Nevertheless, this aspect is not an obstacle to the applicability of ultrasonography in the case of patients suspected of severe or moderate OSAS, since the transverse di- ameters change in dynamics to a greater extent than the anterior-posterior ones. The sensitivity and specificity of this investigation have been demonstrated in the studies performed on the role of ultrasonography 3,7,8 .…”

Section: Discussionmentioning

confidence: 84%

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The role of ultrasound in the diagnosis of obstructive sleep apnea

Csiszér

Albu

Neagos

et al. 2018

Romanian Journal of Rhinology

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OBJECTIVE. This study examines the association between the severity of obstructive sleep apnea and the pharyngeal parameters using the ultrasound of the submental region. MATERIAL AND METHODS. For this study, data obtained from 40 patients, who had undergone investigations in the Galenus Medical Centre in order to diagnose sleep apnea, was analyzed. The following parameters were compared: the transverse diameter of the retrolingual region, the transverse diameter of the retropalatal region and the tongue base thickness. These regions were measured at different moments of respiration such as: during forced expiration, during forced inspiration and while the patients performed Müller’s Manoeuvre. The neck circumference, the body mass index of patients and the severity of sleep apnea obtained from polysomnography were analyzed. RESULTS. The evaluation of the results revealed: severe obstructive sleep apnea in 16 patients, respectively moderate severity in 10 patients, mild apnea in 4 patients, and no obstructive sleep apnea in 10 patients. Statistically significant results (p<0.05) were found after comparing the parameters obtained in patients with severe apnea versus the parameters in patients without apnea, with mild or respectively moderate apnea. CONCLUSION. Based on the results obtained, we consider that cervical ultrasound is useful in the diagnosis of severe obstructive apnea, identifying the pathological changes of the anatomical structures that basically cause this category of disease. Due to the fact that in our country ultrasound is a relatively inexpensive method, being also a non-irradiating, repeatable and accessible method, it should be more widely applied also in the field of otorhinolaryngology in order to view structures accessible to this type of imaging.

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Section: Discussionmentioning

confidence: 84%

“…The gold standard in OSAS diagnosis is polysomnography, but this investigation does not show the anatomic level where the pathological change occurs. The polysomnography must be supplemented by other investigations [5][6][7][8] .…”

Section: Abstract: Ultrasound Obstructive Sleep Apneamentioning

confidence: 99%

The role of ultrasound in the diagnosis of obstructive sleep apnea

Csiszér

Albu

Neagos

et al. 2018

Romanian Journal of Rhinology

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“…The authors also reported that there were positive correlations between the amount of mandibular setback and reduction in the lateral width of the pharyngeal airway or the amount of hyoid bone displacement. Irani et al [27] reported some significant correlations between mandibular posterior displacement and pharyngeal airway volumes or dimensions, but the authors suggested that the correlations were weak.…”

Section: Discussionmentioning

confidence: 99%

Changes in the hyoid bone, tongue, and oropharyngeal airway space after mandibular setback surgery evaluated by cone-beam computed tomography

Kim

Choi

2020

Maxillofac Plast Reconstr Surg

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Background: Mandibular setback surgery can change the position of the mandible which improves occlusion and facial profile. Surgical movement of the mandible affects the base of the tongue, hyoid bone, and associated tissues, resulting in changes in the pharyngeal airway space. The aim of this study was to analyze the 3-dimensional (3D) changes in the hyoid bone and tongue positions and oropharyngeal airway space after mandibular setback surgery. Methods: A total of 30 pairs of cone-beam computed tomography (CBCT) images taken before and 1 month after surgery were analyzed by measuring changes in the hyoid bone and tongue positions and oropharyngeal airway space. The CBCT images were reoriented using InVivo 5.3 software (Anatomage, San Jose, USA) and landmarks were assigned to establish coordinates in a three-dimensional plane. The mean age of the patients was 21.7 years and the mean amount of mandibular setback was 5.94 mm measured from the B-point. Results: The hyoid bone showed significant posterior and inferior displacement (P < 0.001, P < 0.001, respectively). Significant superior and posterior movements of the tongue were observed (P < 0.05, P < 0.05, respectively). Regarding the velopharyngeal and glossopharyngeal spaces, there were significant reductions in the volume and minimal crosssectional area (P < 0.001). The anteroposterior and transverse widths of the minimal cross-sectional area were decreased (P < 0.001, P < 0.001, respectively). In addition, the amount of mandibular setback positively correlated with the amount of posterior and inferior movement of the hyoid bone (P < 0.05, P < 0.05, respectively). Conclusion: There were significant changes in the hyoid bone, tongue, and airway space after mandibular setback surgery.

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“…When the mandibular position is altered, subsequent changes occur in the positions of the hyoid bone, the tongue, and the soft palate, ultimately altering the dimensions of the PAS. For example, repositioning the mandible anteriorly or posteriorly in an orthognathic surgery, 5,6 or using an intraoral device that advances the mandible forward, 7 may alter the dimensions of the PAS. Thus, we should consider the dimensional changes in the PAS when designing an orthodontic intraoral appliance.…”

Section: Introductionmentioning

confidence: 99%

“…Thus, in order to eliminate other undesired factors affecting the PAS, the data must be taken at the same time and posture, only making modifications in the mandibular position. Previous studies, [5][6][7] however, have used measurements taken from before and after orthodontic treatment, or while wearing a device, all of which presented limitations in maintaining consistent conditions with respect to growth, tongue position, and head posture. Thus, studies pertaining to changes in the PAS following mandibular posterior displacement that is unaffected by factors such as growth, tongue position, and head posture are unprecedented.…”

Section: Introductionmentioning

confidence: 99%

Immediate effects of mandibular posterior displacement on the pharyngeal airway space: A preliminary study

Choi

Kim

et al. 2020

Korean J Orthod

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This study aimed to evaluate the immediate effects of mandibular posterior displacement on the pharyngeal airway space (PAS) by using cephalometric evaluations and to investigate how the surrounding structures are schematically involved. Methods: In this retrospective study, 38 subjects with functional Class III malocclusion and two lateral cephalograms were selected. The first lateral cephalogram was taken with the mandible in the habitual occlusal position, and the second in anterior edge-to-edge bite. Paired t-test was used to analyze changes in the PAS, hyoid bone, tongue, and soft palate, followed by mandibular posterior displacement. Pearson's correlation analysis was used to determine the relationship between the amount of mandibular posterior displacement and other variables. Results: A statistically significant decrease was observed in the PAS following mandibular posterior displacement. Along with mandibular posterior displacement, the tongue decreased in length (p < 0.001) and increased in height (p < 0.05), while the soft palate increased in length, decreased in thickness, and was posteriorly displaced (p < 0.001). The hyoid bone was also posteriorly displaced (p < 0.05). There was no correlation between the amount of mandibular posterior displacement and the measured variables. Conclusions: The PAS showed a statistically significant decrease following mandibular posterior displacement, which was a consequence of retraction of the surrounding structures. However, there were individual variances between the amount of mandibular posterior displacement and the measured variables.

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Pharyngeal airway evaluation after isolated mandibular setback surgery using cone-beam computed tomography

Cited by 33 publications

References 31 publications

The role of ultrasound in the diagnosis of obstructive sleep apnea

The role of ultrasound in the diagnosis of obstructive sleep apnea

Changes in the hyoid bone, tongue, and oropharyngeal airway space after mandibular setback surgery evaluated by cone-beam computed tomography

Immediate effects of mandibular posterior displacement on the pharyngeal airway space: A preliminary study

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