Abstract
BackgroundTwo-jaw surgery including mandibular and maxillary backward movement procedures are commonly performed to correct class III malocclusion. Bimaxillary surgery can reposition the maxillofacial bone together with soft tissue, such as the soft palate and the tongue base. We analyzed changes of pharyngeal airway narrowing to ascertain clinical correlations with the prevalence of snoring after two-jaw surgery.MethodsA prospective clinical study was designed including a survey on snoring and three-dimensional (3D) computed tomography (CT) in class III malocclusion subjects before and after bimaxillary surgery. We conducted an analysis on changes of the posterior pharyngeal space find out clinical correlations with the prevalence of snoring.ResultsAmong 67 subjects, 12 subjects complained about snoring 5 weeks after the surgical correction, and examining the 12 subjects after 6 months, 6 patients complained about the snoring. The current findings demonstrated the attenuation of the largest transverse width (LTW), anteroposterior length (APL), and cross-sectional area (CSA) following bimaxillary surgery given to class III malocclusion patients, particularly at the retropalatal level. The average distance of maxillary posterior movements were measured to be relatively higher (horizontal distance 3.9 mm, vertical distance 2.6 mm) in case of new snorers.ConclusionsThis study found that bimaxillary surgery could lead to the narrowing of upper airway at the retropalatal or retroglossal level as well as triggering snoring in subjects with class III malocclusion. Based on the current clinical findings, we also found that upper airway narrowing at retropalatal level may contribute to increasing the probability of snoring and that polysonography may need to be performed before orthognathic surgery in subjects with class III malocclusion.
Highlights
Two-jaw surgery including mandibular and maxillary backward movement procedures are commonly performed to correct class III malocclusion
There were no subjects who were given a diagnosis of sleep breathing disorders including obstructive sleep apnea (OSA) and primary snoring in advance of surgery
The current findings demonstrated the attenuation of the anteroposterior length (APL), largest transverse width (LTW), and crosssectional area (CSA) following bimaxillary surgery given to class III malocclusion patients, at the retropalatal and retroglossal level
Summary
Two-jaw surgery including mandibular and maxillary backward movement procedures are commonly performed to correct class III malocclusion. We analyzed changes of pharyngeal airway narrowing to ascertain clinical correlations with the prevalence of snoring after two-jaw surgery. Snoring is the resulting sound caused by the structure of the upper airway during sleep. It typically happens on inspiration but may occur on expiration. Snoring is Snoring may be linked with conditions which narrow the upper airway, such as obesity, nasal congestion, craniofacial abnormalities, hypothyroidism, acromegaly, and adenotonsillar hypertrophy. These conditions may result in snoring without OSA or snoring that is presented as a symptom of OSA [1]
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