What are the Surgical Movements in Orthognathic Surgery That Most Affect the Upper Airways? A Three-Dimensional Analysis

Giralt-Hernando, Maria; Valls-Ontañón, Adaia; Haas, Orion Luiz; Masià-Gridilla, Jorge; Hernández–Alfaro, Federico

doi:10.1016/j.joms.2020.10.017

Cited by 21 publications

(7 citation statements)

References 28 publications

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“…Embora o recuo da mandíbula promova redução do volume em certas regiões, o avanço da maxila pode compensá-lo promovendo o aumento em outros locais. Com isso, o real efeito dependerá diretamente da proporção de ganho e perda de volume resultantes (Giralt-Hernando et al, 2021;J. He et al, 2017;Yang et al, 2020).…”

Section: Discussionunclassified

Alterações do volume da via aérea superior após cirurgia bimaxilar para correção de má-oclusão esquelética Classe III: Uma série de casos

Lago

Cordeiro

Klüppel

et al. 2022

RSD

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O objetivo deste estudo foi avaliar o volume de vias aéreas de pacientes com má oclusão esquelética Classe III, submetidos à cirurgia ortognática bimaxilar. A amostra foi composta por 10 pacientes com má oclusão esquelética Classe III, submetidos à cirurgia ortognática bimaxilar. Através da tomografia computadorizada, as medidas volumétricas tridimensionais das vias aéreas foram determinadas utilizando o programa Dolphin Imaging® 11.7 e foram comparadas entre os períodos pré e pós-operatório. Os pacientes foram divididos em dois grupos, (1) diminuição das vias aéreas e (2) aumento das vias aéreas. O grupo 1 apresentou uma redução média de 66,16 ± 52,48 mm² na avaliação bidimensional das vias aéreas e 2311,16 ± 1653,71 mm³ na avaliação tridimensional (p≤ 0,05). Por outro lado, o grupo 2 aumentou 166,5 ± 73,13 mm² e 4116 ± 1323,85 mm³. Não houve correlação entre os valores obtidos com o movimento ósseo, em mm (p≥0,05). Pacientes com deformidade classe III submetidos a cirurgia bimaxilar, a maioria com diminuição das vias aéreas, no entanto, essa diminuição nem sempre ocorre na mesma magnitude para todos os pacientes.

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Section: Discussionunclassified

Alterações do volume da via aérea superior após cirurgia bimaxilar para correção de má-oclusão esquelética Classe III: Uma série de casos

Lago

Cordeiro

Klüppel

et al. 2022

RSD

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“…Pharyngeal airway changes were assessed by superimposing the preoperative pharyngeal airway with the 2 postoperative airways segmented from respective CT scan data set (Figure 5E). Airway volume was measured as nasopharyngeal, oropharyngeal and hypopharyngeal airway as described by Giralt-Hernando et al 6 Nasopharynx was measured from soft tissue pharyngeal wall at the level of FHP-PNS-Sphenoid bone, oropharynx up to most anterior point of C3, and hypopharynx up to soft tissue pharyngeal wall FH-PNS parallel to most anterior pole of body of C4 at an automatic threshold set for pharyngeal airway. Pharyngeal airway was seen to increase by 49% immediate postoperatively and by 75.6% at 2 years follow-up.…”

Section: Postoperative Assessmentmentioning

confidence: 99%

Counter-Clockwise Rotation of Maxillomandibular Complex and Customized Joint Reconstruction as a Single Stage Management for Facial Deformity in Temporomandibular Joint Ankylosis: A 2 Year Follow-Up

Mehrotra

Yadav

Katrolia

et al. 2021

Craniomaxillofacial Trauma & Reconstruction Open

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Study Design: A case report with 2 year follow up. Objective: The aim of this paper is to present a case of bilateral TMJ ankylosis with coexisting dentofacial deformity and occlusal cant, and 2 years follow-up evaluation for changes and relapse in the facial skeletal and airway. Methods: The patient was planned preoperatively by computer simulation for bilateral interposition arthroplasty and surgical jigs, coronoidectomy, detachment of masseter and medial pterygoid muscles from ramus, LeFort 1 osteotomy, temporary maxillomandibular fixation, counter-clockwise rotation of the maxillomandibular complex, maxillary fixation and iliac crest graft, reconstruction of bilateral TMJ with custom-made total joint prosthesis, dermal fat interposition in the joint, reattachment of muscles, maxillomandibular fixation, and active physiotherapy. Results: Average ramal length improved by 28.35 mm (81%) in the immediate postoperative and 25.6 mm (73.45%) at 2 years, showing 2.75 mm (4.4%) vertical bone resorption at the angle region. Point A advanced by 1.3 mm, but showed 4.5% horizontal relapse; Point B advanced by 10.2 mm, but showed 9.5% relapse at 2 years. Pogonion advanced by 26.3 mm (70%) but presented 7 mm (10.9%) horizontal relapse; and menton by 28.6 mm (89%) with 5.4 mm (8.9%) relapse at 2 years. The mean mandibular plane angle decreased by 33.5° (42%) after surgery and by 32° (40%) at 2 years. Pharyngeal airway increased by 49% after surgery and by 75.6% at 2 years follow-up. Conclusion: This computer simulated approach for the management of bilateral TMJ ankylosis with facial deformity and occlusal cant improves aesthetics, function and airway in a single surgery, thereby reducing the management cost and time, and deliver precise results.

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“…Orthognathic surgery is a treatment option for the improvement of facial aesthetics and establishment of ideal occlusion in patients with severe skeletal discrepancies [5]. Following orthognathic surgery, the pharyngeal airway space (PAS) goes through substantial changes owing to its functional and anatomical relationships with both the maxilla and mandible [6].…”

Section: Introductionmentioning

confidence: 99%

“…The anterior-posterior and vertical changes at B point and pogonion between T2 and T1 were also insufficiently related to the changes in the SA, MSA, and AP and TV width. (6) The airway changes in the volume, SA, and AP and TV width following surgery (between T0 and T0) according to the extraction and non-extraction of the premolars in the presurgical orthodontic treatment phases (Table 8)…”

mentioning

confidence: 99%

Correlation Analysis between Three‐Dimensional Changes in Pharyngeal Airway Space and Skeletal Changes in Patients with Skeletal Class II Malocclusion following Orthognathic Surgery

Kim

Hwang

Yul

et al. 2022

BioMed Research International

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Introduction. Studies on the pharyngeal airway space (PAS) changes using three-dimensional computed tomography (CT) have shed more light on patients with Class III than Class II malocclusion. This paper focuses on analyzing the long-term changes in the PAS and evaluating the postoperative association between these PAS and skeletal changes in patients with skeletal Class II malocclusion who have undergone orthognathic surgery. Methods. The records of 21 patients with skeletal Class II malocclusion who had undergone orthognathic surgery were included. The anatomical modifications in both jaws, changes in volume, sectional area (SA), minimum sectional area (MSA), and anterior-posterior (AP) and transverse (TV) width in the airway at one month before surgery ( T 0 ), and one month ( T 1 ) and one year ( T 2 ) after surgery were analyzed using CT images. The association between the skeletal and airway changes was evaluated between T 0 , T 1 , and T 2 . Results. After surgery, the ANS, A point, and PNS demonstrated significant posterior and superior movement. The B point and the pogonion exhibited substantial anterior and superior movement. The total and inferior oropharyngeal volumes (vol 3, vol 4) notably increased, while the nasopharyngeal volume (vol 1) decreased. The anterior-posterior movement at the ANS and PNS after surgery was significantly associated with the total volume, vol 2, vol 3, SA 1, MSA, and TV width 1, while substantial association with the total volume was found at the pogonion. Conclusion. Thus, an ideal treatment plan can be formulated for patients with skeletal Class II malocclusion by considering the postoperative PAS changes.

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What are the Surgical Movements in Orthognathic Surgery That Most Affect the Upper Airways? A Three-Dimensional Analysis

Cited by 21 publications

References 28 publications

Alterações do volume da via aérea superior após cirurgia bimaxilar para correção de má-oclusão esquelética Classe III: Uma série de casos

Alterações do volume da via aérea superior após cirurgia bimaxilar para correção de má-oclusão esquelética Classe III: Uma série de casos

Counter-Clockwise Rotation of Maxillomandibular Complex and Customized Joint Reconstruction as a Single Stage Management for Facial Deformity in Temporomandibular Joint Ankylosis: A 2 Year Follow-Up

Correlation Analysis between Three‐Dimensional Changes in Pharyngeal Airway Space and Skeletal Changes in Patients with Skeletal Class II Malocclusion following Orthognathic Surgery

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