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

2020 ◽  
Vol 90 (5) ◽  
pp. 715-722 ◽  
Author(s):  
Luiza Roberta Bin ◽  
Liogi Iwaki Filho ◽  
Amanda Lury Yamashita ◽  
Gustavo Nascimento de Souza Pinto ◽  
Rui Amaral Mendes ◽  
...  
Keyword(s):  
Orthognathic Surgery ◽  
Mixed Model ◽  
Linear Measurements ◽  
Pharyngeal Airway ◽  
Mandibular Setback ◽  
Kappa Test ◽  
Maxillomandibular Advancement ◽  
Maxillary Advancement ◽  
Bimaxillary Orthognathic Surgery ◽  
Group 2

ABSTRACT 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.

scholarly journals Dimensional changes of maxillary sinuses and pharyngeal airway in Class III patients undergoing bimaxillary orthognathic surgery

2013 ◽  
Vol 83 (5) ◽  
pp. 824-831 ◽  
Author(s):  
Eleni Panou ◽  
Melih Motro ◽  
Mustafa Ateş ◽  
Ahu Acar ◽  
Nejat Erverdi
Keyword(s):  
Orthognathic Surgery ◽  
Class Iii ◽  
Cross Sectional ◽  
Dimensional Changes ◽  
Pharyngeal Airway ◽  
Mandibular Setback ◽  
Bimaxillary Orthognathic Surgery ◽  
Significant Change ◽  
The Relationship ◽  
Maxillary Sinuses

ABSTRACT Objective: To evaluate the pharyngeal airway and maxillary sinus volume changes after mandibular setback surgery combined with maxillary advancement and/or impaction surgery. Materials and Methods: Seventeen Class III skeletal patients (11 females, 6 males) who required bimaxillary orthognathic surgery were selected. Volumetric measurements were performed using cone beam computed tomography (CBCT) scans preoperatively and 3.9 ± 0.87 months postoperatively. All the CBCT scans were assessed and analyzed using MIMICS 14.0 software. Preoperative and postoperative volumes of pharyngeal airway and maxillary sinuses and the relationship between the amounts of surgical movement of the jaws and the above volumes were statistically evaluated. Results: The pharyngeal airway area presented no significant change except for the lower and total pharyngeal airway volumes in males, in whom a significant decrease was observed (4196.27 ± 2061.11 mm3 and 3375.53 ± 3624.67 mm3, respectively). No significant change was observed in the minimal cross-sectional area of the pharyngeal airway. There was a significant decrease in the volume of the maxillary sinuses after the surgery by 3448.09 ± 3315.56 mm3. No correlation was found between the amount of skeletal movement and the change in the volume of pharyngeal airway or maxillary sinuses. Conclusion: There was a significant decrease only for lower and total pharyngeal airway volumes in males and a significant decrease in the volume of the maxillary sinuses.

scholarly journals Evaluation of upper airways after bimaxillary orthognathic surgery in patients with skeletal Class III pattern using cone-beam computed tomography

2016 ◽  
Vol 21 (1) ◽  
pp. 34-41 ◽  
Author(s):  
Marília Spínola Azevêdo ◽  
Andre Wilson Machado ◽  
Inêssa da Silva Barbosa ◽  
Lucas Senhorinho Esteves ◽  
Vanessa Álvares Castro Rocha ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Orthognathic Surgery ◽  
Upper Airway ◽  
Cone Beam ◽  
Class Iii ◽  
Upper Airways ◽  
Mandibular Setback ◽  
Maxillary Advancement ◽  
Bimaxillary Orthognathic Surgery

Introduction: It has been suggested that mandibular setback surgery, combined or not with maxillary advancement as a treatment alternative for patients with mandibular prognathism, can induce changes in upper airway space (UAS). Therefore, this study aimed to assess the response of the upper airway in the oropharynx region of patients with Class III skeletal pattern that underwent bimaxillary orthognathic surgery (maxillary advancement and mandibular setback) combined with mentoplasty. Material and Methods: The sample comprised 26 cone-beam computed tomography (CBCT) scans of 13 patients. The examination was taken before and after surgery. UAS volume, sagittal area, length and minimal axial area with its width, depth and location, were measured with the aid of Dolphin ImagingTM software version 11.5 Premium. Data were statistically treated by applying Shapiro-Wilk test and Student's paired t-test, considering as statistically significant the results of which p-value was lower than 0.05. Results: No statistically significant differences were found in any measurements evaluated. Conclusions: No significant changes were observed in the oropharynx after bimaxillary orthognathic surgery and mentoplasty.

scholarly journals Pharyngeal airway changes after bimaxillary orthognathic surgery - preliminary results

2015 ◽  
Vol 143 (5-6) ◽  
pp. 267-273 ◽  
Author(s):  
Neda Stefanovic ◽  
Branislav Glisic ◽  
Predrag Nikolic ◽  
Jovana Juloski ◽  
Juan Palomo
Keyword(s):  
Orthognathic Surgery ◽  
Statistical Significance ◽  
Three Dimensional ◽  
Time Points ◽  
Pharyngeal Airway ◽  
Paired Samples ◽  
Maxillary Advancement ◽  
Dentofacial Deformity ◽  
Bimaxillary Orthognathic Surgery ◽  
Facial Proportions

Introduction. Dentofacial deformity, a deviation from normal facial proportions and dental relationships, is corrected by jaw repositioning in all three spatial planes, which changes the position and tension of the surrounding tissues, bones and muscles. These changes may also affect the dimensions of the pharyngeal airways (PA). Objective. The aim of this study was to evaluate and compare three-dimensional PA changes in patients treated by a combination mandibular set-back/maxillary advancement versus patients that had bimaxillary advancement with genioplasty. Methods. The sample consisted of 7 patients treated by combined mandibular set-back/maxillary advancement and 7 patients treated with bimaxillary advancement surgery. Nasopharyngeal (NP) volume, oropharyngeal (OP) volume and the area of maximum constriction (AMC) in the OP were measured on CBCT scans (2 mA/120 kV/12?? FOV) taken before (T1) and 3 months after surgery (T2). Paired samples t-test was used for analyzing statistical significance of changes (p?0.05). Results. OP volume and AMC increase after bimaxillary advancement was statistically significant, while for the mandibular set-back group the increase was non-significant. NP volume was not reduced in any of the two groups. No significant differences in PA dimensions were found between groups at neither T1 nor T2 time points. Conclusion. Results suggest that the combination of mandibular set-back/maxillary advancement did not reduce airway dimensions, while bimaxillary advancement surgery led to a statistically significant increase in the OP dimensions.

Pharyngeal Airway Changes in Class III Patients Treated With Double Jaw Orthognathic Surgery—Maxillary Advancement and Mandibular Setback

2012 ◽  
Vol 70 (11) ◽  
pp. e639-e647 ◽  
Author(s):  
Otávio Emmel Becker ◽  
Rafael Linard Avelar ◽  
Juliana Gonçalvez Göelzer ◽  
André do Nascimento Dolzan ◽  
Orion Luíz Haas Júnior ◽  
...  
Keyword(s):  
Orthognathic Surgery ◽  
Class Iii ◽  
Pharyngeal Airway ◽  
Mandibular Setback ◽  
Maxillary Advancement

scholarly journals Computational Fluid Dynamic Analysis of the Pharyngeal Airway after Bimaxillary Orthognathic Surgery in Patients with Mandibular Prognathism

Processes ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 152
Author(s):  
Puneet Wadhwa ◽  
Hyon-Seok Jang ◽  
Se-Hyun Park ◽  
Hyoung-Ho Kim ◽  
Eui-Seok Lee
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Pressure Drop ◽  
Orthognathic Surgery ◽  
Treatment Plan ◽  
Pressure Coefficient ◽  
Patient Specific ◽  
Mandibular Prognathism ◽  
Pharyngeal Airway ◽  
Bimaxillary Orthognathic Surgery

This study aimed to analyze pharyngeal airflow characteristics and their relationship with the skeletal movement of the maxilla and mandible after bimaxillary orthognathic surgery in patients with skeletal class III (mandibular prognathism) malocclusion. Cone-beam computed tomography (CBCT) was conducted before surgery (T0), immediately after surgery (T1), and at least six months after surgery (T2). Digital imaging and communications in medicine files were transferred to InVivo (Anatomage) software to measure the skeletal changes after surgery. The changes in the maxillary and mandibular position, tongue position, and hyoid bone position were analyzed. Patient-specific models were reconstructed using 3D-Doctor software. The models after converting to the stereolithography (STL) file for Ansys integrated computer engineering and manufacturing code for computational fluid dynamics (ICEM CFD), commercial software were used for calculating the geometry, pressure drop and adjusted pressure coefficient value. The total volume of the upper airway including nasal cavity was reduced by 23% immediately after surgery and recovered to 92.2% of the initial volume six months after surgery. The airflow computation analysis showed a decrease in the pressure drop values immediately after surgery and six months after surgery. The adjusted pressure coefficients were slightly different but the change was statistically insignificant. The airflow characteristics computed using the computational fluid dynamics were correlated to the surgical changes. The surgical changes can affect the aerodynamics of the pharyngeal airway. In clinical practice, this knowledge is useful for developing a suitable orthognathic surgery treatment plan.

scholarly journals A randomised trial evaluating the effect of intraoperative iron administration

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Bora Lee ◽  
Eun Jung Kim ◽  
Jaewoo Song ◽  
Young-Soo Jung ◽  
Bon-Nyeo Koo
Keyword(s):  
Orthognathic Surgery ◽  
Randomised Trial ◽  
Laboratory Data ◽  
Intravenous Iron ◽  
Iron Bioavailability ◽  
Control Group ◽  
Iron Group ◽  
Bimaxillary Orthognathic Surgery ◽  
Group 2 ◽  
Postoperative Haemoglobin

Abstract Perioperative anaemia increases postoperative morbidity and mortality, and iron deficiency is anaemia’s most common cause in surgical patients. Preoperative intravenous iron increases postoperative haemoglobin; however, data regarding intraoperative intravenous iron’s effectiveness are inadequate. This study examined intraoperative intravenous iron’s effects on postoperative haemoglobin levels in adults. Fifty-seven healthy subjects (aged 19–40 years) scheduled for bimaxillary orthognathic surgery were assigned randomly to the iron (n = 28) or control (n = 29) groups. The iron group received intravenous ferric derisomaltose (1,000 mg) after anaesthetic induction. The control group received an identical volume of intravenous normal saline. The primary outcome was postoperative haemoglobin level. Secondary outcomes included other postoperative haematologic and iron parameters. Laboratory data were obtained preoperatively and at 1 day, 2 weeks, and 4 weeks postoperatively. Haemoglobin was higher in the iron group 2 weeks postoperatively (12.9 g/dL vs. 12.2 g/dL), but the between-group difference was not significant after adjustment for multiple testing. However, the reticulocyte production index was significantly higher in the iron group 2 weeks postoperatively. Intraoperative intravenous iron maintains postoperative haemoglobin values in patients undergoing bimaxillary orthognathic surgery by increasing haematopoietic function and iron bioavailability and therefore appears to be a useful strategy for blood management.

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