scholarly journals Effect of posterior impaction and setback of the maxilla on retropalatal airway and velopharyngeal dimensions after two-jaw surgery in skeletal Class III patients

2015 ◽  
Vol 85 (4) ◽  
pp. 625-630 ◽  
Author(s):  
Taeyun Kim ◽  
Seung-Hak Baek ◽  
Jin-Young Choi
Keyword(s):  
Soft Palate ◽  
Cross Sectional Area ◽  
T Test ◽  
Sectional Area ◽  
Class Iii ◽  
Cross Sectional ◽  
Skeletal Class ◽  
Group 2 ◽  
Jaw Surgery ◽  
Group 1

ABSTRACT Objective:  To evaluate the changes in retropalatal airway and velopharyngeal dimensions after posterior impaction (PI) only or PI and setback (PI/SB) of the maxilla in patients with skeletal Class III undergoing two-jaw surgery. Materials and Methods:  Subjects consisted of 60 Class III patients treated with two-jaw surgery. They were divided into two groups: group 1 (n  = 30; PI of the maxilla; mean  =  2.6 mm) and group 2 (n = 30; PI/SB of the maxilla; mean  =  2.8 mm and 1.8 mm, respectively). Using three dimensional computed tomography images taken 1month before surgery (T0) and at least 6 months after surgery (T1), retropalatal airway volume, minimum cross-sectional area, and lateral and anteroposterior (AP) dimensions of minimum cross-sectional area, soft palate angle, soft palate length, and pharyngeal depth were measured. A paired t-test and independent t-test were used for statistical analysis. Results:  Group 1 showed increase in retropalatal airway volume and minimum cross-sectional area (P < .01 and P < .05, respectively). Group 2 exhibited decrease in retropalatal airway volume, minimum cross-sectional area, and lateral and AP dimensions of minimum cross-sectional area (all P < .01). Although groups 1 and 2 showed an increase in soft palate length (P < .01 and P < .001, respectively), pharyngeal depth significantly increased only in group 1 (P < .01). Groups 1 and 2 were significantly different in retropalatal airway volume, minimum cross-sectional area, and AP dimension (P < .05, P < .001, and P < .05, respectively). Conclusion:  Because the direction of surgical movement in the maxilla can determine the changes in the retropalatal airway and velopharyngeal dimensions, it is recommended that clinicians investigate whether patients suffer from sleep-related breathing disorders before performing PI/SB of the maxilla.

Upper Airway 3D Changes of Patients With Cleft Lip and Palate After Orthognathic Surgery

2018 ◽  
Vol 56 (3) ◽  
pp. 314-320 ◽  
Author(s):  
Marilia Sayako Yatabe-Ioshida ◽  
Letícia Dominguez Campos ◽  
Renato Yassukata Yaedu ◽  
Ivy Kiemle Trindade-Suedam
Keyword(s):  
Orthognathic Surgery ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Upper Airway ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Class Iii ◽  
Linear Measurements ◽  
Cross Sectional ◽  
Skeletal Class

Objectives: The purpose of this study was to 3-dimensionally assess the airway characteristics of patients with unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) who underwent orthognathic surgery. Design: This was a retrospective study. Setting: The study took place at a national referral center for cleft lip and palate rehabilitation. Patients and Participants: The sample comprised cone-beam computed tomography (CBCT) scans obtained before and after orthognathic surgery of 15 individuals (30 CBCT scans), divided into 2 groups: UCLP group (n = 9 patients/18 CBCT scans) and BCLP group (n = 6/12 CBCT scans). All patients had a nonsyndromic UCLP or BCLP and a skeletal class III malocclusion at the preoperative period. Interventions: Airway volume, pharyngeal minimal cross-sectional area (mCSA), location of mCSA, sella-nasion-A point (SNA) and sella-nasion-B point (SNB) angles, and condylion-A point and condyloid-gnathion linear measurements were assessed in open-source software (ITK-SNAP and SlicerCMF). Main Outcome Measure: Airway dimensions of patients with UCLP and BCLP increase after orthognathic surgery. Results: After orthognathic surgery, UCLP group showed a significant 20% increase in nasopharynx volume. Although not significant, BCLP group also showed an increase of 18% in the same region. Minimal cross-sectional area remained dimensionally stable after surgery and was all located in the oropharynx region, on both groups. Additionally, a positive correlation was observed between volume and mCSA on both groups. Conclusion: Overall, individuals with UCLP and BCLP showed an increase in the upper airway after orthognathic surgery and this might explain the breathing and sleep improvements reported by the patients after the surgery.

scholarly journals 3D geometry of femoral reaming for bone graft harvesting

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Dominic Gehweiler ◽  
Nina Schmitz ◽  
Boyko Gueorguiev ◽  
Ivan Zderic ◽  
Leonard Grünwald ◽  
...  
Keyword(s):  
Ct Scan ◽  
Bone Graft ◽  
Wall Thickness ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Relative Decrease ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

AbstractThe reamer-irrigator-aspirator (RIA) technique allows to collect large bone graft amounts without the drawbacks of iliac crest harvesting. Nevertheless, clinical cases with occurrence of femur fractures have been reported. Therefore, this study aimed to systematically investigate the three-dimensional geometry of the reamed bone as a function of the reaming diameter and its influence on the associated potential fracture pattern. Forty-five intact fresh-frozen human cadaveric femora underwent computed tomography (CT). They were randomized to three groups (n = 15) for reaming at a diameter of either 1.5 mm (Group 1), 2.5 mm (Group 2) or 4.0 mm (Group 3) larger than their isthmus using RIA. Reaming was followed by a second CT scan, biomechanical testing until failure and a third CT scan. All CT scans of each femur were aligned via rigid registration, and fracture lines were visualized. Subsequently, a decrease in wall thickness, cross-sectional area, and harvested bone volume have been evaluated. The total volume of the bone graft was significantly higher for Group 3 (7.8 ± 2.9 ml) compared to Group 1 (2.9 ± 1.1 ml) and Group 2 (3.0 ± 1.1 ml). The maximal relative decrease of the wall thickness was located medially (72.7%) in the third (61.4%), fourth (18.2%) and second (9.1%) eighth for all groups. As the diameter of the reaming increased, an overlap of the fracture line with the maximal relative decrease in wall thickness and a maximal average relative decrease of the cross-sectional area became more frequent. This suggests that a reaming-associated fracture is most likely to occur in this region.

Changes in the parameters of nasal breathing and parameters of the upper respiratory tract during orthognathic operations in patients with II and III skeletal class of jaw anomalies

2020 ◽  
pp. 22-27
Author(s):  
S.Sh. Gammadaeva ◽  
M.I. Misirkhanova ◽  
A.Yu. Drobyshev
Keyword(s):  
Respiratory Tract ◽  
Nasal Cavity ◽  
Nasal Septum ◽  
Cross Sectional Area ◽  
Upper Respiratory Tract ◽  
Sectional Area ◽  
Nasal Breathing ◽  
Cross Sectional ◽  
Skeletal Class ◽  
Upper Respiratory

The study analyzed the functional parameters of nasal breathing, linear parameters of the nasal aperture, nasal cavity and nasopharynx, volumetric parameters of the upper airways in patients with II and III skeletal class of jaw anomalies before and after orthognathic surgery. The respiratory function of the nose was assessed using a rhinomanometric complex. According to rhinoresistometry data, nasal resistance and hydraulic diameter were assessed. According to the data of acoustic rhinometry, the minimum cross-sectional area along the internal valve, the minimum cross-sectional area on the head of the inferior turbinate and nasal septum and related parameters were estimated. According to the CBCT data, the state of the nasal septum, the inferior turbinates, the nasal aperture, the state of the nasal cavity, and the linear values of the upper respiratory tract (nasopharynx) were analyzed. The patients were divided into 4 groups according to the classification of the patency of the nasal passages by

scholarly journals A T-capsulotomy provides increased hip joint visualization compared with an extended interportal capsulotomy

2019 ◽  
Vol 6 (2) ◽  
pp. 157-163 ◽  
Author(s):  
Gregory L Cvetanovich ◽  
David M Levy ◽  
Edward C Beck ◽  
Alexander E Weber ◽  
Benjamin D Kuhns ◽  
...  
Keyword(s):  
High Resolution ◽  
Hip Joint ◽  
Cross Sectional Area ◽  
T Test ◽  
Sectional Area ◽  
Cross Sectional ◽  
Digital Photograph ◽  
Fresh Frozen ◽  
The Cross ◽  
Cadaveric Model

Abstract The purpose of this study was to compare the cross-sectional area (CSA) of joint visualization between extended interportal and T-capsulotomies. Twenty fresh-frozen cadaveric hips were dissected to their capsuloligamentous complexes and fixed in a custom apparatus in neutral hip position. Ten hips underwent sequential interportal capsulotomies at lengths of 2, 4, 6, and 8 cm. Ten hips underwent sequential T-capsulotomies starting from a 4 cm interportal capsulotomy, creating a 2 cm T-capsulotomy (Half-T), and finally a 4 cm T-capsulotomy (Full-T). Following each sequential capsule change in both groups, a high-resolution digital photograph was taken to measure the visualized intra-articular cross-sectional area (CSA). Independent t-test was used to compare CSA interportal and T-capsulotomy groups. Analysis demonstrated a statistically significant increase in CSA visualization with each sequential increase in interportal capsulotomy length up to 6 cm (2cm: 0.6 ± 0.2 cm2; 4cm: 2.1 ± 0.5 cm2 (p<0.001); 6cm: 3.6 ± 1.0 cm2 (p=0.001)), and no difference at 8cm (4.2 ± 1.2 cm2 (p=0.20)). For the T-capsulotomy group the average CSA visualization significantly increased from 3.2 ± 0.9 cm2 for the Half-T to 7.1 ± 1.0 cm2 for the Full-T (p<0.001). The Half-T CSA visualization was not statistically different from the 6 cm capsulotomy (p=0.4) and the 8cm capsulotomy (p=0.05). The Full-T had significantly superior CSA visualization area as compared to the 6 cm and 8 cm interportal capsulotomies (p<0.001 for both). In conclusion, T-capsulotomy resulted in improved cross-sectional area of joint visualization compared to an extended (8cm) interportal capsulotomy in a cadaveric model. Surgeons must weigh the benefits of greater visualization from T-capsulotomy that may help to avoid residual FAI while ensuring to completely repair the capsulotomy to avoid iatrogenic instability.

Morphologic Changes in the Upper Airway of Children during Awakening from Propofol Administration

2002 ◽  
Vol 96 (3) ◽  
pp. 607-611 ◽  
Author(s):  
Ronald S. Litman ◽  
Eric E. Weissend ◽  
David A. Shrier ◽  
Denham S. Ward
Keyword(s):  
Soft Palate ◽  
Upper Airway ◽  
Cross Sectional Area ◽  
Transverse Diameter ◽  
Sectional Area ◽  
Upper Airways ◽  
Cross Sectional ◽  
Propofol Sedation ◽  
The Cross ◽  
Morphologic Changes

Background The purpose of this study was to determine the morphologic changes that occur in the upper airway of children during awakening from propofol sedation. Methods Children undergoing magnetic resonance imaging of the head underwent additional scans of the upper airway during deep sedation with propofol; this was repeated on awakening. Axial views were obtained at the most posterior sites of the pharynx at the levels of the soft palate and tongue. Measurements were then obtained of the anterior-posterior (A-P) diameter, transverse diameter, and cross-sectional areas at these levels. Results Data were obtained on 16 children, aged 10 months to 7 yr. In both sedated and awakening states, most children had the smallest cross-sectional area of the pharynx at the level of the soft palate. During the sedated state, at the soft palate level, the transverse diameter was most narrow in 11 children, the A-P diameter was most narrow in 1 child, and they were equal in 2 children. During the sedated state, at the level of the tongue, the transverse diameter was most narrow in 9 children, the A-P diameter was most narrow in 5 children, and they were equal in 2 children. During awakening, at the soft palate level, the transverse diameter was most narrow in none of the children, the A-P diameter was most narrow in 13 children, and they were equal in 1 child. At the level of the tongue, the transverse diameter was most narrow in 4 children, and the A-P diameter was most narrow in 12 children. During awakening, the A-P diameter of the pharynx at the level of the soft palate decreased in 12 children, increased in 1 child, and remained the same in 1 child. (P &lt; 0.001). The transverse diameter increased in 11 children, decreased in 1 child, and remained the same in 2 children (P = 0.001). The cross-sectional area at the level of the soft palate increased in 4 children, decreased in 8 children, and stayed the same in 2 children (P = 0.5). During awakening, the A-P diameter of the pharynx at the level of the tongue decreased in 11 children, increased in 4 children, and remained the same in 1 child. (P = 0.01). The transverse diameter increased in 11 children and decreased in 5 children (P = 0.07). The cross-sectional area at the level of the tongue increased in 7 children, decreased in 7 children, and stayed the same in 2 children (P = 0.9). Conclusions The dimensions of the upper airways of children change shape significantly on awakening from propofol sedation. When sedated, the upper airway is oblong shaped, with the A-P diameter larger than the transverse diameter. On awakening, the shape of the upper airway in most children changed such that the transverse diameter was larger. Cross-sectional areas between sedated and awakening states were unchanged. These changes may reflect the differential effects of propofol on upper airway musculature during awakening.

Effect of Increasing Depth of Propofol Anesthesia on Upper Airway Configuration in Children

2003 ◽  
Vol 99 (3) ◽  
pp. 596-602 ◽  
Author(s):  
Russell G. Evans ◽  
Mark W. Crawford ◽  
Michael D. Noseworthy ◽  
Shi-Joon Yoo
Keyword(s):  
Confidence Interval ◽  
Soft Palate ◽  
Upper Airway ◽  
Magnetic Resonance Images ◽  
Cross Sectional Area ◽  
Depth Of Anesthesia ◽  
Sectional Area ◽  
Cross Sectional ◽  
Airway Narrowing ◽  
Pharyngeal Airway

Background The upper airway tends to be obstructed during anesthesia in spontaneously breathing patients. The purpose of the current study was to determine the effect of increasing depth of propofol anesthesia on airway size and configuration in children. Methods Magnetic resonance images of the upper airway were obtained in 15 children, aged 2-6 yr. Cross-sectional area, anteroposterior dimension, and transverse dimension were measured at the level of the soft palate, dorsum of the tongue, and tip of the epiglottis. Images were obtained during infusion of propofol at a rate of 50-80 microg.kg-1.min-1 and after increasing the depth of anesthesia by administering a bolus dose of propofol and increasing the infusion rate to 240 microg.kg-1.min-1. Results Overall, the cross-sectional area of the entire pharyngeal airway decreased with increasing depth of anesthesia. The reduction in cross-sectional area was greatest at the level of the epiglottis (24.5 mm2, 95% confidence interval = 16.9-32.2 mm2; P &lt; 0.0001), intermediate at the level of the tongue (19.3 mm2, 95% confidence interval = 9.2-29.3 mm2; P &lt; 0.0001), and least at the level of the soft palate (12.6 mm2, 95% confidence interval = 2.7-22.6 mm2; P &lt; 0.005) in expiration and resulted predominantly from a reduction in anteroposterior dimension. The airway cross-sectional area decreased further in inspiration at the level of the epiglottis. The narrowest portion of the airway resided at the level of the soft palate or epiglottis in the majority of children. Conclusion Increasing depth of propofol anesthesia in children is associated with upper airway narrowing that occurs throughout the entire upper airway and is most pronounced in the hypopharynx at the level of the epiglottis.

scholarly journals Effect of post–orthognathic surgery condylar axis changes on condylar morphology as determined by 3-dimensional surface reconstruction

2013 ◽  
Vol 84 (2) ◽  
pp. 316-321 ◽  
Author(s):  
Soo-Bum An ◽  
Soo-Byung Park ◽  
Yong-Il Kim ◽  
Woo-Sung Son
Keyword(s):  
Orthognathic Surgery ◽  
Pearson Correlation ◽  
Three Dimensional ◽  
Class Iii ◽  
Absolute Deviation ◽  
Skeletal Class ◽  
Before And After ◽  
Group 2 ◽  
Jaw Surgery ◽  
Surface Changes

ABSTRACT Objective: To evaluate the effect of postoperative condylar axis changes on mandibular condylar remodeling by comparing the condylar head in three-dimensional (3D) surface reconstructions before and after surgery in skeletal Class III deformities (one-jaw [mandibular setback] or two-jaw surgery), and also to determine the relationship between condylar inward rotation and condylar surface remodeling after orthognathic surgery. Materials and Methods: A retrospective analysis was conducted of 30 patients with skeletal Class III deformities who had received orthognathic surgery. Group 1 underwent one-jaw surgery (10 men, five women, age 22.4 ± 3.3 years), and group 2 underwent two-jaw surgery (10 men, five women, age 22.3 ± 2.2 years). Sixty condyles were reconstructed and superimposed pre- and postoperatively to compare the changes of condylar surfaces. The relation between the condylar axis change and the surface change using the Pearson correlation were investigated from the 3D image software. Results: Condylar surface changes before and after the surgery were significant. The postoperative inward rotation of the condyles was correlated with the average absolute deviation of the condyles, regardless of the surgery type (one- or 2-jaw surgery; r  =  .70, P &lt; .05). Conclusion: After orthognathic surgery, condylar surface changes occurred, and condylar inward rotation was closely related to changes of condylar surface.

scholarly journals USEFULNESS OF VARIOUS DYNAMIC AND STATIC PARAMETERS IN SLEEP MRI STUDIES -DO THEIR INCORPORATION IN ROUTINE REPORTING IN PATIENTS WITH OBSTRUCTIVE SLEEPAPNEA PROVE VALUABLE ?

2020 ◽  
pp. 1-4
Author(s):  
Amarnath Chellathurai ◽  
Sudhakar Vadivel ◽  
Chezhian Jayabalan ◽  
Priya Muthaiyan ◽  
Sebastian Xavier
Keyword(s):  
Soft Palate ◽  
Relative Size ◽  
Cross Sectional Area ◽  
Respiratory Cycle ◽  
P Value ◽  
Airway Compromise ◽  
Sectional Area ◽  
Cross Sectional ◽  
Obstructive Sleep ◽  
The Mean

Background: Sleep MRI is a new emerging non invasive modality in the preoperative evaluation of patients with obstructive sleep apnoea. Rather than subjective, the aim of the study is to evaluate the competency of certain dynamic and static parameters (variables and diemensions), that can be used in day to day reporting. Incorporating such parameters, may prove to be helpful in guiding surgical decision making. Materials and Methods: A retrospective analytical study included 27 subjects with OSA aged between 18 and 70 years using 1.5 T MRI . We measured variables such as the cross-sectional area and diameter of the retropalatal and retroglossal airway during the asleep and awakened states.We also measured comprehensive airway dimensions such as antero-posterior diameter of the tongue, midline saggital diameter of tongue, intermandibular rami distance, mentum spine distance and relative size of the tongue using the spine as the posterior border of the bony confines. Results: 21 patients had significant retropalatal airway compromise, and was evidenced by statistically significant variables in awakened and asleep states. The mean minimum anterior–posterior diameter (mm) of retropalatal airway during respiratory cycle was statistically significant measuring 3.1±1.5 mm in awaken state and 1.1±1.5 mm during asleep state (p- value 0.01). The mean minimum cross sectional area during respiratory cycle was statistically significant measuring 98±11 mm2 in awaken state and 63 ±12 mm2 during asleep state (p- value 0.04). 6 patients had significant retroglossal airway compromise, and was evidenced by statistically significant. The thickness of the soft palate and the relative size of the tongue (0.5± 0.01mm) was statistically significant in these patients (p- value 0.01). Conclusion: Our study shows that retropalatal airway is a significant cause of obstruction in patients with OSA, compared with retroglossal airway. We suggest that, when the compromise of the retroplatine aiway is to be evaluated, variables such as cross sectional area and antero-posterior diameter of the retropalatal airway during the respiratory phase in asleep and awakened states proves valuable and dimensions such as soft palate thickness as tool for objective measurement of OSA. When the compromise of the retroglossal aiway is to be evaluated, the relative size of the tongue , proves offers more advantage than the variables of airway compromise such as area and antero-posterior diameter.To further evaluate if some of our parameters correlate with the outcomes of the surgeries of OSA, a multivariate analysis would have been required.

Morphologic and morphometric features of the calcaneal insertions of the superficial digital flexor tendon in the horse

2014 ◽  
Vol 27 (05) ◽  
pp. 366-371 ◽  
Author(s):  
I. M. Wright ◽  
W. H. J. Barker
Keyword(s):  
Flexor Tendon ◽  
Biceps Femoris ◽  
Cross Sectional Area ◽  
T Test ◽  
Sectional Area ◽  
Cross Sectional ◽  
Plantar Surface ◽  
Paired Student ◽  
Morphometric Features ◽  
Superficial Digital Flexor Tendon

SummaryIntroduction: Accurate description of the calcaneal insertions of the superficial digital flexor tendon (SDFT) is lacking and inconsistent. The aim of this study was to undertake morphologic and morphometic evaluations of these structures to assist in elucidating their functional and pathogenic roles in displacement of the SDFT from the calcaneal tuber.Method: Dissections were performed on 10 normal cadaveric hindlimbs. The anatomy was photographed to allow measurements at repeatable locations and differences in SDFT dimensions at the various locations were compared using a paired student t-test.Results: This study demonstrated that the calcaneal insertions of the SDFT are independent from the overlying tarsal insertions of the biceps femoris and semitendinosus, which blend into the plantar surface of the fibrocartilaginous cap (FCC) of the SDFT before inserting dorsal to the insertion of the SDFT on the calcaneal tuber. The lateral insertion of the SDFT is larger in cross-sectional area (median: 219 mm2) at its origin from the FCC than its medial counterpart (median: 159 mm2, p = 0.004) and has a more complex fibre alignment. The lateral site of attachment of the SDFT on the calcaneal tuber is dorsolateral to the insertion of the gastrocnemius tendon and is larger (median: 525 mm2) than the medial insertion (median: 428 mm2, p = 0.036), which inserts distal to the insertion of the gastrocnemius tendon.Conclusion: The features identified in this study suggest that the calcaneal insertions of the SDFT are complex and their morphological and morphometric differences are likely to contribute to clinical lesions identified at this site.

scholarly journals Correlation between sagittal jaw position and jaw relationship in children with skeletal class III malocclusion

2018 ◽  
Vol 146 (1-2) ◽  
pp. 12-19
Author(s):  
Zdenka Stojanovic ◽  
Zlata Brkic ◽  
Predrag Vucinic ◽  
Predrag Nikolic ◽  
Marjan Marjanovic
Keyword(s):  
Test Group ◽  
Mixed Dentition ◽  
Control Group ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Skeletal Class ◽  
Everyday Work ◽  
Group 2 ◽  
Jaw Position ◽  
Group 1

Introduction/Objective. The evaluation of sagittal jaw relationship is crucial in orthodontic diagnostics, orthodontic treatment planning, and monitoring of its results. A large number of parameters have been established for their assessment. The aim of this study was to determine the significance of the correlation between the indicators of sagittal jaw relationship, ANB, AOBO, AFBF, NAPg, and OJ, one with another, and with indicators of the sagittal position of the jaws, SNA and SNB, in children with skeletal class III malocclusion. Methods. A total of 100 children with mixed dentition, of both genders, based on the profile cephalometric analysis, were divided into two equal groups: group 1 (test group) ? children with skeletal class III (n = 50), group 2 (control group) ? children with skeletal class I (n = 50). Results. In children with skeletal class III malocclusion, significant correlations were found among the indicators of sagittal jaw relationships ANB, AOBO, AFBF, NAPg, OJ, mutually, except between AOBO and AFBF. Significant correlations of these parameters were also found with the SNB angle, but not with the SNA angle. Conclusion. Confirmed significant correlation between tested indicators in the sagittal jaw relation indicates that, if we find skeletal jaw relationship class III, or just a simple reversed incisors overbite in children in routine application of any of the above mentioned parameters in everyday work, it should be indubitably checked and monitored using a larger number of parameters, especially those that define the sagittal position of the mandible.

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