scholarly journals Changes in Pharyngeal Airway After Mandibular Setback Surgery: A Retrospective Cephalometric Study

2019 ◽  
Vol 53 (4) ◽  
pp. 256-263
Author(s):  
Jayshree D. Daryanani ◽  
N. Vijay ◽  
K. Sadashiva Shetty ◽  
Riddhi Chawla
Keyword(s):  
Soft Palate ◽  
Sagittal Split Ramus Osteotomy ◽  
Mandibular Prognathism ◽  
Pharyngeal Airway ◽  
Mandibular Setback ◽  
Mandibular Setback Surgery ◽  
Cephalometric Study ◽  
Base Of The Tongue

Aim: To cephalometrically evaluate the alterations taking place in the pharyngeal airway space, hyoid bone, soft palate, and head posture after mandibular setback surgery (bilateral sagittal split osteotomy) for correction of mandibular prognathism, as well as to evaluate the immediate postsurgical and more than 6 months postsurgical adaptations of these structures. Setting and Design: A retrospective cephalometric study. Materials and Method: The study group consisted of 40 nongrowing patients (20 females and 20 males) with mandibular prognathism and ANB less than or equal to –2 degree for which mandibular setback surgery by bilateral sagittal split ramus osteotomy was performed along with fixed appliance therapy. There presurgical (T1), immediate postsurgical (T2), and more than 6 months postsurgical (T3) lateral cephalograms were analyzed. Statistical Analysis Used: Intragroup comparison was done by paired t-test. Results: Skeletal measurements after orthognathic surgery remained stable in the long term. It was evident that mandibular setback surgery narrowed the pharyngeal airway; however, these changes were not significant except at the base of the tongue. During the follow-up airway measurements at the base of the tongue, the intersection of tongue at the inferior border of mandible and the vallecula increased but they did not reach the presurgical values. Soft palate length increased significantly after surgery. Angulation of soft palate to nasal line also increased significantly following surgery but decreased during follow-up. Extension of the head occurred after surgery which was maintained even at long term. Conclusion: Careful analysis of airway should be performed, particularly in connection with large anteroposterior discrepancies and in those who have risk factors for development of obstructive sleep apnea. Such cases should be corrected by combined maxillary and mandibular osteotomies.

scholarly journals The Changes of Cheek Line (Lateral) and Face Line (Frontal) after Correction of Mandibular Prognathism

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Yu-Chuan Tseng ◽  
Jung-Hsuan Cheng ◽  
Michael Yuan-Chien Chen ◽  
Kwei-Jing Chen ◽  
Chun-Ming Chen
Keyword(s):  
Null Hypothesis ◽  
Sagittal Split Ramus Osteotomy ◽  
Facial Profile ◽  
Mandibular Prognathism ◽  
Postoperative Change ◽  
Mandibular Setback ◽  
Mandibular Setback Surgery

Objective. The purpose of the present study was to investigate the improvements of facial profile and postoperative stability by single mandibular setback surgery. Materials and Methods. The study included twenty-seven patients who underwent mandibular prognathism correction by sagittal split ramus osteotomy (SSRO). Cephalometric radiograms (lateral and frontal) were collected and analyzed at three intervals: preoperatively (T1), immediately postoperatively (T2), and final follow-up postoperatively (T3). The lateral and frontal cephalometric parameters were measured. The immediate postoperative change (T21), postoperative stability (T32), and final surgical change (T31) were calculated and analyzed. The null hypothesis is that postoperative stability (T32) was not significantly correlated to amount of mandibular setback (T21). Results. The immediate postoperative change (T21) of menton (Me) was significantly backward 8.7 mm. In the final postoperative change (T31), average chin points anterior movements were approximately 0.32 mm. Investigating frontal appearance, inter ramus posterior (InterRp) and intergonion (InterGo) widths were significantly increased with 1.8 and 2.2 mm, respectively. Bilateral ramus angles were not significantly increased, about 1°. The horizontal Me (T32) had significant correlation (p=0.028) with amount of setback (T21). Therefore, null hypothesis is rejected. Conclusion. Postoperative relapse was significantly correlated to the amount of setback. The frontal transverse changes (InterRp and InterGo) were significantly increased.

scholarly journals Multislice computed tomography assessment of airway patency changes in the supine position following mandibular setback surgery for mandibular prognathism: A prospective 1-year follow-up study

2021 ◽  
Vol 11 ◽  
pp. 106-115
Author(s):  
Koji Iwai ◽  
Hiroshi Ueda ◽  
Toshikazu Nagasaki ◽  
Cynthia Concepcion Medina ◽  
Yu Matsumura ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Multislice Computed Tomography ◽  
University Hospital ◽  
Airway Patency ◽  
Mandibular Prognathism ◽  
Pharyngeal Airway ◽  
Mandibular Setback ◽  
Post Surgery ◽  
Mandibular Setback Surgery

Objectives: The purpose of this study was to perform a three-dimensional analysis on the pharyngeal airway of supine patients who have undergone mandibular setback surgery, using multislice computed tomography (MSCT). We also measured the respiratory disturbance index pre- and post-surgery, using a portable sleep monitor. Materials and Methods: The subjects included two males and nine females who were diagnosed with mandibular prognathism at Hiroshima University Hospital and were scheduled to undergo the bilateral sagittal split osteotomy. Using a CT scanner, baseline MSCT images were obtained from the subjects before surgery for morphological analysis, and then the two further scans were obtained after mandibular setback surgery. All patients were provided with at-hoeme sleep monitor to use it both at baseline and approximately 1 year after surgery. Results: Middle and epiglottis pharyngeal space and cross-sectional area were significantly decreased immediately after setback surgery, but did not change further over the 1-year period. Mandibular setback was not associated with the development of sleep breathing disorder (SBD) during the 1-year follow-up period. Conclusion: We found no evidence that the reduction in the pharyngeal airway space immediately after mandibular setback surgery recovered significantly during the follow-up period, although mandibular setback was not associated with development of SBD.

scholarly journals Review the Impact of Mandibular Setback Surgery for the Correction of Class III Malocclusion on the Upper Airway Space

2021 ◽  
Vol 9 (F) ◽  
pp. 644-649
Author(s):  
Dareen Aljehani
Keyword(s):  
Upper Airway ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Eligibility Criteria ◽  
Pharyngeal Airway ◽  
Mandibular Setback ◽  
Obstructive Sleep ◽  
Mandibular Setback Surgery ◽  
The Impact

AIM: This study aimed to review the scientific evidence related to the effect of mandibular setback surgery for the correction of Class III malocclusion on the changes in volume and anatomical structures’ positions of the upper airway within at least 1 year follow-up. METHODS: An electronic research was conducted on PubMed, Google scholar, and Elsevier up to April 20, 2021, the inclusion criteria were prospective or retrospective studies aiming to compare the changes in upper airway space following isolated mandibular setback through at least 1 year of follow-up. RESULTS: A total of 84 studies were retrieved, only 12 studies met the eligibility criteria. Their methods of measurement were using lateral cephalometry, CT, or Cone-beam computed tomography. Most of them showed narrowing in the Pharyngeal airway space, with some variability within the follow-up periods. Impact on the possibility of obstructive sleep apnea (OSA) was discussed in most of the included studies. CONCLUSION: Narrowing of upper airway volume is associated with isolated mandibular setback surgeries within 1 year of follow-up. However, OSA was not necessarily a consequence. Any predisposing factors for OSA should be considered before isolated mandibular setback surgery.

scholarly journals Postoperative Skeletal Stability and Pharyngeal Airway: Counterclockwise versus Clockwise Rotation during Mandibular Setback Surgery

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Yu-Chuan Tseng ◽  
Szu-Yu Hsiao ◽  
Jung-Hsuan Cheng ◽  
Kun-Jung Hsu ◽  
Chun-Ming Chen
Keyword(s):  
Soft Palate ◽  
Clockwise Rotation ◽  
Time Intervals ◽  
Physiological Regulation ◽  
Pharyngeal Airway ◽  
Mandibular Setback ◽  
The Mean ◽  
Mandibular Setback Surgery ◽  
Craniovertebral Angle ◽  
Skeletal Stability

Purpose. To compare the effects of counterclockwise rotation (CCR) and clockwise rotation (CR) of the mandible on the pharyngeal airway during mandibular setback surgery. Materials and Methods. Serial cephalograms of 40 patients with mandibular prognathism, including 20 who underwent CCR and 20 who underwent CR, were taken at the following time intervals: preoperatively (T1), immediately postoperatively (T2), >1 year after surgery (T3), final surgical changes (T31), postoperative stability (T32), and immediate surgical change (T21). Changes in menton (Me) and hyoid (H) positions, soft palate width, soft palate length, soft palate angle and craniovertebral angle (C2C4-SN), and pharyngeal airway spaces (nasal pharyngeal airway (NOP), uvula pharyngeal airway (UOP), tongue pharyngeal airway (TOP), and epiglottis pharyngeal airway (EOP)) were evaluated. Results. The mean Me (T31) setback for CCR and CR was 12.56 and 13.06 mm, respectively, with 2.41 mm upward and 3.29 mm downward, respectively. The vertical Me position of CR exhibited significant downward movement compared with that of CCR. The mean H setback results for CCR and CR were 4.42 and 5.75 mm, respectively, with 1.47 mm downward and 2.97 mm downward, respectively. The C4C2-SN angles for CCR and CR increased by 2.68° and 3.65°, respectively, whereas their palatal angles increased by 2.35° and 5.25°, respectively. Pearson’s correlation analysis (T31) revealed that for CCR, no pharyngeal airway spaces were significantly correlated with any measured variables. In CR, NOP was significantly correlated (r = 0.58) with the vertical Me position. Significant relapse (T32) was observed after CR in the horizontal (r = −0.72) and vertical (r = −0.82) Me positions. Conclusion. Pharyngeal airway space narrowed postoperatively, and its patency was appropriately maintained through natural physiological regulation of the craniovertebral angle (C2C4-SN). Significant postoperative relapse was correlated with CR.

scholarly journals Correlation between the Pharyngeal Airway Space and Head Posture after Surgery for Mandibular Prognathism

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Chun-Ming Chen ◽  
Steven Lai ◽  
Ker-Kong Chen ◽  
Huey-Er Lee
Keyword(s):  
Mandibular Prognathism ◽  
Head Posture ◽  
Oropharyngeal Airway ◽  
Pharyngeal Airway ◽  
Mandibular Setback ◽  
Postoperative Changes ◽  
Lateral Cephalograms ◽  
Intraoral Vertical Ramus Osteotomy ◽  
Mandibular Setback Surgery ◽  
Vertical Ramus Osteotomy

Purpose. The aim of this study was to determine the correlation between the pharyngeal airway space and head posture after mandibular setback surgery for mandibular prognathism.Materials and Methods. Serial lateral cephalograms of 37 patients with mandibular prognathism who underwent intraoral vertical ramus osteotomy (IVRO) were evaluated before (T1) and immediately (T2), between 6 weeks and 3 months (T3), and more than 1 year (T4) after surgery. Pairedt-tests and Pearson’s correlation analysis were used to evaluate the postoperative changes in all cephalometric parameters, including the mandible, hyoid, head posture (craniocervical angle), and pharyngeal airway space.Results. The mandible and hyoid were set back by 12.8 mm and 4.9 mm, respectively, at T2. Furthermore, the hyoid showed significant inferior movement of 10.7 mm, with an 8 mm increase in the tongue depth. The upper oropharyngeal airway (UOP) shortened by 4.1 mm, the lower oropharyngeal airway (LOP) by 1.7 mm, and the laryngopharyngeal airway by 2 mm. The craniocervical angle showed a significant increase of 2.8°. UOP and LOP showed a significant correlation with the craniocervical angle at T2 and T4.Conclusions. Our findings conclude that the oropharyngeal airway space is significantly decreased and correlated with a change in the head posture after mandibular setback surgery.

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