Three-dimensional pharyngeal airway space changes after bimaxillary advancement.

Arnaldo Pinzan,Eduardo Sant’Ana,Thaís Lima Rocha,Ludmila Lima,Renato Luiz Maia Nogueira,Guilherme Janson,Caroline Nemetz Bronfman

doi:10.1590/2177-6709.26.5.e2119364.oar

Abstract

ABSTRACTIntroduction: The probability of improvement in the upper airway space (UAS) with orthognathic surgery should be considered during the surgical-orthodontic treatment decision, providing not only an esthetic, but also a functional benefit for the patient. Objective: The purpose of this study was to evaluate the 3D changes in the upper airway space after maxillomandibular advancement surgery (MMA). Methods: A retrospective analysis of 56 patients, 21 male and 35 female, with a mean age of 35.8 ± 10.7 years, who underwent MMA was performed. Pre- and postoperative cone-beam computed tomography scans (CBCT) were obtained for each patient, and the changes in the UAS were compared using Dolphin Imaging 11.7 software. Two parameters of the pharyngeal airway space (PAS) were measured: airway volume (AV) and minimum axial area (MAA). Paired t-test was used to compare the data between T0 and T1, at 5% significance level. Results: There was a statistically significant increase in the UAS. Bimaxillary advancement surgery increased the AV and the MAA, on average, by 73.6 ± 74.75% and 113.5 ± 123.87%, respectively. Conclusion: MMA surgery tends to cause significant increase in the UAS; however, this increase is largely variable.

Highlights

The probability of improvement in the upper airway space (UAS) with orthognathic surgery should be considered during the surgical-orthodontic treatment decision, providing an esthetic, and a functional benefit for the patient
The purpose of this study was to evaluate the 3D changes in the upper airway space after maxillomandibular advancement surgery (MMA)
The UAS anatomical conformation allows factors such as obesity, muscle hypotonicity and mandibular deficiency to favor the obstruction, generating Obstructive Sleep Apnea (OSA), which has been the subject of numerous studies.[4,5,6,7]

Summary

Introduction

The probability of improvement in the upper airway space (UAS) with orthognathic surgery should be considered during the surgical-orthodontic treatment decision, providing an esthetic, and a functional benefit for the patient. For the correct indication of treatment, an accurate malocclusion and skeletal discrepancy diagnosis is needed. This care leads to adequate planning and multidisciplinary treatment with the objective of an esthetic and functional correction.[1]. Dissatisfaction with facial esthetics is considered the most common motivating factor in the search for orthognathic surgery, since this is the procedure indicated in cases of severe dental and skeletal discrepancies in adult patients.[2]. The UAS anatomical conformation allows factors such as obesity, muscle hypotonicity and mandibular deficiency to favor the obstruction, generating Obstructive Sleep Apnea (OSA), which has been the subject of numerous studies.[4,5,6,7]

Methods

Results

Discussion

Conclusion