The impact of Le Fort I advancement and bilateral sagittal split osteotomy setback on ventilation during sleep

Computerized Cephalometric Study of the Pharyngeal Airway Space in Patients Submitted to Orthognathic Surgery

“…This agrees with Paoli et al [37] who mentioned that the risk of development of obstructive sleep apnea should be included as a parameter for indication of mandibular setback, and with Ramesh et al [38] who observed considerable reduction of the airway space in all patients, predisposing them to obstructive sleep apnea. Considering our results and accordingly with others authors [39][40][41][42], anteroposterior discrepancies may be corrected by combined maxillomandibular osteotomies, when this does not impair the aesthetic result of the procedure. Thus, it may be concluded that maxillomandibular orthognathic surgery for correction of mandibular prognathism did not statistically significantly change the upper (nasopharynx), middle (oropharynx) and lower (hypopharynx) pharyngeal airway spaces.…”

Changes in posterior airway space, pulmonary function and sleep quality, following bimaxillary orthognathic surgery

“…MARSAN et al 21 determined a significant upward and backward movement of HB in the first week and a relapse in HB position 1.3 AE 0.2 years after BOS. FOLTÁ N et al 16 observed HB position distance between mandibular plane and HB increased to 133%; which means HB positioned inferiorly 8.5 months after BOS. Posteroinferior displacement of the HB has generally been noted immediately after MS, carrying the tongue backward and downward, but followed by a tendency to return to its original position 2,5,7 .…”

“…Another study showed that BOS resulted in the reduction of the retropalatal dimension but was not significant after 2 years and was much less than in the group which only had MS 14 . FOLTÁ N et al 16 determined a 75% decrease in PAS after 8.5 months post surgery; but the authors investigated PAS only at the shortest distance between the tongue and dorsal pharyngeal wall and established the reduction only at that level. SAMMAN et al 9 compared pre-and post BOS measurements at 6 months followup regarding changes in PAS dimensions with 19 female subjects and found statistically significant decreases at the oropharyngeal and hypopharyngeal levels.…”

“…Efforts to improve occlusion and facial aesthetics, and consequently the patient's quality of life, may have the opposite effect 16 . Creating upper airway resistance by surgical procedures could influence the respiration adversely.…”

“…KITA-GAWARA et al 8 investigated the effects of MS on PAS using cephalograms and on arterial oxygen saturation (SpO 2 ) during sleep (measured by pulse oximetry); and determined that SpO 2 decreased during sleep just after surgery, but had improved 1 month after MS. FOLTÁ N et al 16 examined the impact of OS for Class III malocclusion on ventilation during sleep and determined a significant increase in the index of flow limitations and decrease in oxygen saturation. TURNBULL & BATTA-GEL 19 investigated PAS in OS patients, which were included in the study irrespective of the type of maxillo-mandibular surgery, using cephalometric radiographs.…”