Three-dimensional Airway Changes Research Articles

Three-Dimensional Airway Changes and AHI Reduction Following Maxillomandibular Advancement and Genioglossus Advancement in Patients with Obstructive Sleep Apnea

Three-Dimensional Airway Changes and AHI Reduction Following Maxillomandibular Advancement and Genioglossus Advancement in Patients with Obstructive Sleep Apnea

A comparative study of three-dimensional airway changes after fibula flap reconstruction for benign and malignant tumours in the anterior mandible

Surgical treatment of tumours in the anterior mandible and surrounding tissues may result in defects which can be restored by a fibula free flap. The upper airway may change during this process. The purpose of this retrospective study was to evaluate upper airway changes after fibula free flap reconstruction. A total of 37 patients who underwent anterior mandibulectomy and fibula free flap reconstruction between 2012 and 2020 were recruited. Patients with benign and malignant tumours involving the anterior mandible were included. Spiral computed tomography was performed 1 week preoperatively, 1 week postoperatively, and at> 1 year (range 12–23 months) after surgery. Cross-sectional areas and volumes of the upper airway were measured. Data were analysed by two-way analysis of variance. The upper airway in the malignant tumour group showed an increasing trend, especially at the soft palate and tongue base levels (P < 0.01). In the benign tumour group, the upper airway showed no significant changes. The location of the minimum cross-sectional area moved downwards in both groups, and the area increased in the malignant tumour group during long-term follow-up. Upper airway obstruction is less likely to occur in the long term after surgical resection of anterior mandible malignancies and fibula free flap reconstruction.

Three-dimensional airway changes after adenotonsillectomy in children with obstructive apnea: Do expectations meet reality?

The assessment of the volumetric changes of the airways after adenotonsillectomy has gained popularity among orthodontists, but the validity of such evaluation is not clear. Thirty patients with obstructive sleep apnea diagnosed with the use of polysomnography (PSG) were evaluated according to the Apnea and Hypopnea Index (AHI), the obstructive apnea index (OAI), the oxygen desaturation index (ODI), the lowest oxygen saturation (LSpO2), and the average oxygen saturation (ASpO2). The volume and the minimal cross-section of lower (oropharynx and velopharynx) and upper (nasopharynx) spaces of the airways were calculated. Patients were adenotonsillectomized; posttreatment data were collected after 12months. Thirty comparison patients also had the volume of airways evaluated. A statistically significant improvement (P<0.05) of most PSG parameters was observed after adenotonsillectomy: AHI from 14.5 to 5.2, OAI from 9.4 to 5.5, ODI from 14.6 to 6.5, and LSpO2 from 77% to 94%). A significant increase in airway volume of the lower space (from 2571.5mm3 to 5276.3mm3) and the upper space (from 726mm3 to 1056.9mm3), as well as in the minimal cross-section of the airways (from 98.5mm2 to 335.8mm2) was found in adenotonsillectomy patients. No significant volumetric changes of the airways were observed in the comparison patients. No significantcorrelation was found between PSG parameters and the dimensions of the airways before adenotonsillectomy. No significant correlation was found between changes of the PSG parameters and changes of the dimensions of the airways 12months after the adenotonsillectomy. Adenotonsillectomy contributed to the increase of the airway volume and minimal cross-section, and to the improvement of the PSG parameters, but there was no correlation between the magnitude of the anatomic changes and the improvement of the breathing mode.

3D Airway changes using cone beam computed tomography in patients following mandibular advancement surgery with and without constriction

The aim of this study was to compare three-dimensional airway changes resulting from mandibular advancement surgery and mandibular advancement surgery with constriction. The University of Michigan School of Dentistry and Medical Center. A total of 42 patients undergoing mandibular advancement with or without simultaneous constriction. A retrospective airway evaluation of patients undergoing mandibular advancement with or without simultaneous mandibular constriction was performed. Cross-sectional evaluation at standardized locations, minimum cross section and volumetric analysis were performed using Dolphin Imaging TM Version 11.7. Patients undergoing mandibular advancement with or without constriction experienced significant airway increases (P<0.05). Patients who underwent mandibular advancement only gained nearly twice as much airway volume as mandibular advancement with simultaneous constriction (8.69mm3 vs 4.3mm3 ). The largest increase for both groups was observed in the minimum axial area in the oropharynx segment (119.5mm2 ) and the axial area of the retroglossal region (137.2mm2 ). The findings demonstrate mandibular advancement with constriction results in airway enlargement following surgery.

Three-dimensional airway changes after orthodontic extraction treatment in class II and hyperdivergent adults: a preliminary study using cone beam computed tomography

Three-dimensional airway changes after orthodontic extraction treatment in class II and hyperdivergent adults: a preliminary study using cone beam computed tomography

Effects of unilateral vertical mandibular distraction osteogenesis on airway anatomy in children with hemifacial microsomia

PurposeTo assess the two- and three-dimensional airway changes following unilateral vertical mandibular distraction osteogenesis (vMDO) in patients with hemifacial microsomia (HFM). MethodsA retrospective evaluation was performed for consecutive patients over an 18-month period with HFM and with Kaban-Pruzansky Type-II mandibular deformities who underwent unilateral vMDO for correction of vertical mandibular asymmetry. Patients with complete records and a minimum of 12 months of clinical follow-up post-consolidation were included. Pre-operative airway dimensions (diameters, cross-sectional areas, and volumes) were measured for the oropharynx and nasopharynx. Pre-operative airway dimensions were compared to post-distraction measurements taken from 3D-CT data obtained at a minimum of 3 months post-consolidation. ResultsFive patients met inclusion criteria. Median age was 12.6 years, 3 were female, and median distraction length was 21.3 mm. Median final follow-up CT was performed 5 months after completion of distraction. There were no major or minor complications. Median total airway volume change was +33.7%, corresponding to median volume changes of 80.5% and 10.5% for the oropharyngeal and nasopharyngeal airways, respectively. ConclusionUnilateral vMDO expands the minimum diameter and volume of the oropharyngeal to a greater extent than the nasopharyngeal airway in HFM patients with Kaban-Pruzansky Type-II mandibular deformities.

Three-dimensional airway changes after subcranial Le Fort III osteotomy combined with Le Fort I osteotomy

Three-dimensional airway changes after subcranial Le Fort III osteotomy combined with Le Fort I osteotomy

Three-Dimensional Airway Changes in Children With Congenital Micrognathia and Obstructive Sleep Apnea Following Mandibular Distraction Osteogenesis

was applied to all patients and involved the intravenous injection of the bone targeting radiopharmaceutical 99mTc MDP (7.4 MBq/kg, maximum of 518 MBq). 3-D regions-of-interest (ROIs) were applied to the condyles and maximum counts of both condyles. Methods of Data Analysis: Data from each condyle was standardized to an external source and a ratio of R/L condylar uptake was calculated and compared to agematched normal values. The uptake ratio was determined to be high, normal, or low. Each patient was then categorized as normal or abnormal, symmetric or asymmetric based on blinded evaluation of the SPECT scan results. Patient records were then obtained and results of the SPECT scans were compared to the clinical assessment and follow up data. Results of Investigation: Eleven patients (n 11, 0 male, 11 female, ages 12-44 years, mean 19) were referred for a SPECT Tc99 scan of the condyles. Five of the scans showed normal and symmetric activity bilaterally. All of these patients had quiescent or end-stage growth abnormalities and the SPECT results correlated with their clinical diagnosis. Two of these scans exhibited abnormal R/L ratios and this correlated with the clinical diagnosis of condylar hyperplasia on the side with increased uptake. Four scans demonstrated bilateral symmetric uptake with higher-than-normal activity. Two of the 4 exhibited continued symmetric growth clinically and the other two had active bilateral idiopathic condylar resorption. Conclusion: The results of this preliminary study indicate that age-matched normative data is useful in evaluating asymmetric and symmetric abnormalities in mandibular growth. The application of established agematched normal ranges of condylar activity using SPECT Tc99 is useful in guiding the management of patients with suspected condylar hyperplasia, condylar hypoplasia, and idiopathic condylar resorption and may be useful in assessment of activity of inflammatory joint disease.