Change of the upper airway after mandibular setback surgery in patients with mandibular prognathism and anterior open bite

Abstract Purpose It has been reported before that the amount of pharyngeal airway space (PAS) significantly decreases following mandibular setback (MS) surgery in patients with mandibular prognathism (MP). Further, MP patients with an anterior open-bite (AOB) presentation may show a larger decrease...

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Main Authors: Kyungjin Lee, Soon Jung Hwang
Format: Article
Language:English
Published: SpringerOpen 2019-11-01
Series:Maxillofacial Plastic and Reconstructive Surgery
Subjects:
Online Access:http://link.springer.com/article/10.1186/s40902-019-0230-4
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author Kyungjin Lee
Soon Jung Hwang
author_facet Kyungjin Lee
Soon Jung Hwang
author_sort Kyungjin Lee
collection DOAJ
description Abstract Purpose It has been reported before that the amount of pharyngeal airway space (PAS) significantly decreases following mandibular setback (MS) surgery in patients with mandibular prognathism (MP). Further, MP patients with an anterior open-bite (AOB) presentation may show a larger decrease in PAS compared with those without AOB. However, studies on postoperative PAS changes in MP patients with AOB remain rare. This study sought to evaluate changes in PAS and hyoid bone positioning following MS surgery in MP patients with and without AOB. Patients and methods Twenty patients who underwent two jaw surgery involving MS movement were included. Patients were divided into a non-AOB group (n = 10; overbite > 2 mm) and an AOB group (n = 10; overbite < − 4 mm). Three-dimensional changes in PAS and hyoid bone positioning were compared and statistically evaluated pre- and postoperatively using computed tomography (CT). Results The mean magnitude of MS was 6.0 ± 2.8 mm and 5.6 ± 3.2 mm in the non-AOB group and AOB group, respectively. The oropharyngeal volume and upper hypopharyngeal volume were significantly reduced after surgery in both the groups (p = 0.006 and p = 0.003), while the retroglossal cross-sectional area was significantly reduced only in the AOB group (p = 0.028). Although the AOB group showed a larger decrease in PAS, the difference was not statistically significant between the groups. The position of the hyoid bone showed significant posterior and inferior displacement only in the AOB group, while the vertical displacement of the hyoid bone showed a statistically significant difference between the two groups. Conclusion PAS was significantly decreased after MS in both the groups, while only the AOB group presented a statistically significant reduction in the retroglossal cross-sectional area. Vertical displacement of the hyoid bone showed a statistically significant difference between the groups, while the PAS change was not. Surgeons should be aware of potential postoperative airway problems that may arise when performing MS surgeries.
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spelling doaj.art-34f7a387a7374ed7a7bd1249c866ef602022-12-22T01:30:12ZengSpringerOpenMaxillofacial Plastic and Reconstructive Surgery2288-85862019-11-014111810.1186/s40902-019-0230-4Change of the upper airway after mandibular setback surgery in patients with mandibular prognathism and anterior open biteKyungjin Lee0Soon Jung Hwang1Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National UniversityHSJ Dental Clinic for Oral and Maxillofacial SurgeryAbstract Purpose It has been reported before that the amount of pharyngeal airway space (PAS) significantly decreases following mandibular setback (MS) surgery in patients with mandibular prognathism (MP). Further, MP patients with an anterior open-bite (AOB) presentation may show a larger decrease in PAS compared with those without AOB. However, studies on postoperative PAS changes in MP patients with AOB remain rare. This study sought to evaluate changes in PAS and hyoid bone positioning following MS surgery in MP patients with and without AOB. Patients and methods Twenty patients who underwent two jaw surgery involving MS movement were included. Patients were divided into a non-AOB group (n = 10; overbite > 2 mm) and an AOB group (n = 10; overbite < − 4 mm). Three-dimensional changes in PAS and hyoid bone positioning were compared and statistically evaluated pre- and postoperatively using computed tomography (CT). Results The mean magnitude of MS was 6.0 ± 2.8 mm and 5.6 ± 3.2 mm in the non-AOB group and AOB group, respectively. The oropharyngeal volume and upper hypopharyngeal volume were significantly reduced after surgery in both the groups (p = 0.006 and p = 0.003), while the retroglossal cross-sectional area was significantly reduced only in the AOB group (p = 0.028). Although the AOB group showed a larger decrease in PAS, the difference was not statistically significant between the groups. The position of the hyoid bone showed significant posterior and inferior displacement only in the AOB group, while the vertical displacement of the hyoid bone showed a statistically significant difference between the two groups. Conclusion PAS was significantly decreased after MS in both the groups, while only the AOB group presented a statistically significant reduction in the retroglossal cross-sectional area. Vertical displacement of the hyoid bone showed a statistically significant difference between the groups, while the PAS change was not. Surgeons should be aware of potential postoperative airway problems that may arise when performing MS surgeries.http://link.springer.com/article/10.1186/s40902-019-0230-4Mandibular setbackPharyngeal airway spaceMandibular prognathismOpen-biteHyoid bone
spellingShingle Kyungjin Lee
Soon Jung Hwang
Change of the upper airway after mandibular setback surgery in patients with mandibular prognathism and anterior open bite
Maxillofacial Plastic and Reconstructive Surgery
Mandibular setback
Pharyngeal airway space
Mandibular prognathism
Open-bite
Hyoid bone
title Change of the upper airway after mandibular setback surgery in patients with mandibular prognathism and anterior open bite
title_full Change of the upper airway after mandibular setback surgery in patients with mandibular prognathism and anterior open bite
title_fullStr Change of the upper airway after mandibular setback surgery in patients with mandibular prognathism and anterior open bite
title_full_unstemmed Change of the upper airway after mandibular setback surgery in patients with mandibular prognathism and anterior open bite
title_short Change of the upper airway after mandibular setback surgery in patients with mandibular prognathism and anterior open bite
title_sort change of the upper airway after mandibular setback surgery in patients with mandibular prognathism and anterior open bite
topic Mandibular setback
Pharyngeal airway space
Mandibular prognathism
Open-bite
Hyoid bone
url http://link.springer.com/article/10.1186/s40902-019-0230-4
work_keys_str_mv AT kyungjinlee changeoftheupperairwayaftermandibularsetbacksurgeryinpatientswithmandibularprognathismandanterioropenbite
AT soonjunghwang changeoftheupperairwayaftermandibularsetbacksurgeryinpatientswithmandibularprognathismandanterioropenbite