Cephalometric Evaluation of Airway Changes Following Mandibular Distraction in Patients with Nocturnal Desaturations During Sleep Secondary to TMJ Ankylosis

Abstract

The objective of this study was to cephalometrically evaluate the changes in the oro-pharyngeal airway and its correlation to the clinical outcome following mandibular distraction in patients with sleep disordered breathing secondary to tempero-mandibular joint (TMJ) ankylosis. Five patients diagnosed as having nocturnal desaturations during sleep secondary to TMJ ankylosis were evaluated in this study. They were evaluated pre and post mandibular distraction using cephalometry, to determine changes in their oro-pharyngeal airway space and, upper and lower airway dimensions. An attempt was made to correlate these changes to the clinical outcome of the procedure by over-night pulse-oximetry. The patients showed a mean increase of 31.33% in the oro-pharyngeal airway space with a 3.8% increase in the oxygen saturation levels. The change in the airway space dimensions and area was directly proportional to the oxygen saturation observed in the patients. The patients in this series did not show a very high apnoea hypopnoea index but had a compromised airway which resulted in sub-optimal sleep patterns. Mandibular distraction in these patients not only improved their esthetics but also proved to aid their functional rehabilitation by significantly increasing their oro-pharyngeal space and reducing their sleep disturbances.