Three-dimensional alterations in pharyngeal airspace, soft palate, and hyoid bone of class II and class III patients submitted to bimaxillary orthognathic surgery: A retrospective study

Pinto, Gustavo Nascimento de Souza; Filho, Liogi Iwaki; Previdelli, Isolde Terezinha Santos; Ramos, Adilson Luiz; Yamashita, Amanda Lury; Stabile, Glaykon Alex Vitti; Pereira-Stabile, Cecília Luiz; Iwaki, Lílian Cristina Vessoni

doi:10.1016/j.jcms.2019.03.015

Cited by 34 publications

(22 citation statements)

References 45 publications

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“…11 Thus, in this study, PAS was divided into two segments to analyze the effect of each surgical procedure 10 especially on MAA. 10,28 MAA appears to be relevant since some authors pointed out that there might be a risk of developing obstructive sleep apnea secondary to orthognathic procedures. 8,11 Previous studies 8,10,28 demonstrated that maxillary advancement with mandibular setback could increase the total volume of the PAS, in agreement with the findings of this study.…”

Section: Discussionmentioning

confidence: 99%

How does bimaxillary orthognathic surgery change dimensions of maxillary sinuses and pharyngeal airway space?

Bin¹,

Filho²,

Yamashita³

et al. 2020

The Angle Orthodontist

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Objectives To assess changes in the maxillary sinus (MS) and pharyngeal airway space (PAS) after bimaxillary orthognathic surgery using cone-beam computed tomography (CBCT). Materials and Methods The CBCT scans of 48 patients were divided into two groups: group 1: maxillary advancement and mandibular setback (n = 24); group 2: maxillomandibular advancement (n = 24). The CBCTs were acquired 1 to 2 months preoperatively and 6 to 8 months postoperatively. A kappa test was used to determine intra- and interexaminer agreement. Area, volume, and linear measurements of MSs and PASs obtained before and after surgery were compared using a mixed model (P < .05). Results All variables of the MS showed significant postsurgical reductions in both groups, except the MS length, which showed a significant increase in group 2. Volume and minimum axial area of PAS showed statistically significant postsurgical increases in both groups (P < .05). Conclusions Despite the reduction in the MS and the increase in the PAS, results indicated that the airway was not negatively affected after maxillomandibular advancement and maxillary advancement with mandibular setback.

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Section: Discussionmentioning

confidence: 99%

How does bimaxillary orthognathic surgery change dimensions of maxillary sinuses and pharyngeal airway space?

Bin¹,

Filho²,

Yamashita³

et al. 2020

The Angle Orthodontist

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“…The examinations were obtained at two intervals as part of the surgical protocol: 1‐month preoperatively to assist diagnostics and 3D VSP, and 1‐month postoperatively, to ascertain early surgery outcomes . The patients were instructed to adopt a natural head position (NHP) by looking at their own eyes in a mirror on the opposite wall, with their tongues and lips at rest, breathing lightly and avoiding swallowing during image acquisition . The support for the chin and head was used for the initial positioning but was removed during image acquisition as they could be confused with the soft tissues and negatively affect the VSP .…”

Section: Methodsmentioning

confidence: 99%

Accuracy of 3D virtual surgical planning for maxillary positioning and orientation in orthognathic surgery

Tonin

Filho

Yamashita

et al. 2020

Orthod Craniofacial Res

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Objective This retrospective and observational study evaluated the accuracy of a 3D virtual surgical planning (VSP) for the maxillary positioning and orientation in patients undergoing bimaxillary orthognathic surgery, comparing the planned and postoperative outcomes. Setting and Sample Population Seventy consecutive patients of both sexes, who were submitted to bimaxillary orthognathic surgery between 2015 and 2019 were included in our study. Material and Methods The patients were evaluated by fusing preoperative planning and postoperative outcome using cone‐beam computed tomography scan evaluation. Three‐dimensional VSP and postoperative outcomes were compared by using three linear and three angular measurements. The main outcome interest was the difference between the VSP movement, and the surgical movement obtained. The success criterion adopted was a mean linear difference of <2 mm and a mean angular difference of <4°. Results Results were analysed using a linear mixed model with fixed and random effects, at α = .05. No significant statistical differences were found for linear and angular measurements between the planned and postsurgical outcomes (P > .05). All overlapping points presented values within the range considered clinically irrelevant (<2 mm; <1°). Conclusions Three‐dimensional VSP was executed with a high degree of accuracy. When comparing the planned and postsurgical outcomes, all overlapping points presented values within the range considered clinically irrelevant.

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“…Definitions of landmarks, reference planes and cephalometric angular measurements were taken from these reconstructed cephalometric images (Figure A). Traditional measurements were used to determine the positions of the maxilla and the mandible. The horizontal ( x ) and vertical ( y ) positions of the selected landmarks were described based on coordinates relative to a reference plane parallel to the Frankfort horizontal plane, and passing through the sella, with the sella as the origin.…”

Section: Methodsmentioning

confidence: 99%

Relationship between pharyngeal airway depth and ventilation condition in mandibular setback surgery: A computational fluid dynamics study

Shirazawa

Iwasaki

Ooi

et al. 2020

Orthod Craniofacial Res

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Objectives: This study aimed to determine the anteroposterior depth (APD) of the pharyngeal airway (PA) where post-operative PA obstruction was predicted, using computer fluid dynamics (CFD), in order to prevent obstructive sleep apnoea after mandibular setback surgery. Settings and sample population: Nineteen skeletal Class III patients (8 men; mean age, 26.7 years) who required mandibular setback surgery had computed tomography images taken before and 6 months after surgery. Methods: The APD of each site of the four cross-sectional reference planes (retropalatal airway [RA], second cervical vertebral airway, oropharyngeal airway and third cervical vertebral airway) were measured. The Maximum negative pressure (Pmax) of the PA was measured at inspiration using CFD, based on a three-dimensional PA model. Intersite differences were determined using analysis of variance and the Friedman test with Bonferroni correction. The relationship between APD and Pmax was evaluated by Spearman correlation coefficients and non-linear regression analysis. Results: The smallest PA site was the RA. Pmax was significantly correlated with the APD of the RA (r s = .628, P < .001). The relationship between Pmax and the APD-RA was fitted to a curve, which showed an inversely proportional relationship of Pmax to the square of the APD-RA. Pmax substantially increased even with a slight reduction of the APD-RA. In particular, when the APD-RA was 7 mm or less, Pmax increased greatly, suggesting that PA obstruction was more likely to occur. Conclusions: The results of this study suggest that APD-RA is a useful predictor of good PA ventilation after surgery. K E Y W O R D S computational fluid dynamics, mandibular setback surgery, obstructive sleep apnoea, pharyngeal airway depth, skeletal class III How to cite this article: Shirazawa Y, Iwasaki T, Ooi K, et al. Relationship between pharyngeal airway depth and ventilation condition in mandibular setback surgery: A computational fluid dynamics study.

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Three-dimensional alterations in pharyngeal airspace, soft palate, and hyoid bone of class II and class III patients submitted to bimaxillary orthognathic surgery: A retrospective study

Cited by 34 publications

References 45 publications

How does bimaxillary orthognathic surgery change dimensions of maxillary sinuses and pharyngeal airway space?

How does bimaxillary orthognathic surgery change dimensions of maxillary sinuses and pharyngeal airway space?

Accuracy of 3D virtual surgical planning for maxillary positioning and orientation in orthognathic surgery

Relationship between pharyngeal airway depth and ventilation condition in mandibular setback surgery: A computational fluid dynamics study

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