CHANGES OF THE HYOID BONE POSITION AND THE UPPER AIRWAY DIMENSION AFTER ORTHOGNATHIC SURGERY IN SKELETAL CLASS III PATIENTS

골격성 3급 부정교합자의 악교정 수술 후 설골 위치와 상기도 크기의 변화

  • Kim, Ji-Yong (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Yongdong Severance Hospital) ;
  • Ahn, Je-Young (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Yongdong Severance Hospital) ;
  • Lim, Jae-Hyung (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Yongdong Severance Hospital) ;
  • Huh, Jong-Ki (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Yongdong Severance Hospital) ;
  • Park, Kwang-Ho (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Yongdong Severance Hospital)
  • 김지용 (연세대학교 치과대학 구강악안면외과학교실 영동세브란스병원) ;
  • 안제영 (연세대학교 치과대학 구강악안면외과학교실 영동세브란스병원) ;
  • 임재형 (연세대학교 치과대학 구강악안면외과학교실 영동세브란스병원) ;
  • 허종기 (연세대학교 치과대학 구강악안면외과학교실 영동세브란스병원) ;
  • 박광호 (연세대학교 치과대학 구강악안면외과학교실 영동세브란스병원)
  • Published : 2006.01.31

Abstract

After orthognathic surgery in skeletal class III patients, the hyoid bone position and the upper airway dimension could be changed due to mandibular setback. There has been many studies about airway dimension of the patients with skeletal class II malocclusion or obstructive sleep apnea. but not with skeletal class III. The purpose of this study was to examine the change of position of the hyoid bone and the consequent change of airway space as the result of retrusion of mandible after orthognathic surgery in skeletal Cl III malocclusion patients. It is also to apply this results in predicting, diagnosing and treating the subsequent obstructive sleep apnea. Forty patients who were diagnosed as skeletal Cl III maloccusion, received orthoganthic surgery of both jaws including mandibular setback, and were followed up post-operatively for more than 6 months were selected. There were 10 male patients 30 female patients. The preoperative and postoperative lateral cephalograms were traced and the distances and angles were measured. The nasopharyngeal space increased postoperatively while the oropharyngeal space decreased. Except for the change of oroparyngeal space, the changes in male patients were greater than female patients. The hyoid bone moved in the posterior-inferior direction, and the change was greater in males than in females. If the postoperative mandibular setback is great, then a significant decrease of airway space and posterior and inferior movement of the hyoid bone were observed. This can result in symptoms related to obstructive sleep apnea. This result should be considered in the diagnosis and treatment planning of orthognathic surgery patients.

Keywords

References

  1. Stepovich ML : A cephalometric positional study of hyoid bone. Am J Orthod 51 : 882, 1965 https://doi.org/10.1016/0002-9416(65)90202-2
  2. Bibby RE, Preston CB : The hyoid triangle. Am J Orthod 80 : 92, 1981 https://doi.org/10.1016/0002-9416(81)90199-8
  3. Myung-kuk Kim : Head and neck anatomy. Vol 3 : 171-79, 1995
  4. Yung-il Chang : The study of hyoid bone position. Kor J Orthodontics 17 : 7, 1987
  5. Kyung-wook Kim, Jong-il Choung, Chul-hwan Kim : A cephalometric study on changes in hyoid bone, tongue and upper airway space according to skeletal change in persons with mandible prognathsm after orthognathic surgery. J Kor Acad Maxillo Pla Reconstr Surg 26 : 3, 2004
  6. Athanasious AE, Nick T, Dimitrios M et al : Alternations of hyoid bone position pharyngeal deph and their relationship after surgical correction of mandibular pprognathism. Am J Orthod 100 : 259-61, 1991 https://doi.org/10.1016/0889-5406(91)70063-3
  7. Wickwire NA, White RP Jr, Proffit WR : The effect of mandibular osteotomy on tongue position. J Oral Surg 30 : 184, 1972
  8. Greco JM, Frohberg U, Van sickeles JE : Long-term airway space changes after mandibular setback using bilateral sagittal split osteotomy. Int J Oral Maxillofac Surg 19 : 103, 1990 https://doi.org/10.1016/S0901-5027(05)80204-8
  9. Kwang-ho Park, Jin-song Bae, Kyung-ho Kim : Cephalometric study of posterior airway space and hyoid bone position in patients affected by class II malocclusion and treated with orthognathic surgery. Kor J Maxillofac plast Reconst 23 : 527, 2001
  10. Henriksson CO, Linder-Aronson S, Westborg B : Roentgenological changes in anteroposterior nasopharyngeal dimensions in 6 to 15 year old. Dentomaxillofac Radiol 4 : 19, 1975
  11. Holmberg H. Linder-Aronson S : Cephalometric radiographs as a mean of evaluating the capacity of the nasal and nasopharyngeal airway.Am J Orthod Dentfac Orthop 76 : 497, 1985
  12. Reley RW, Powell NB, Guilleminault C : Current surgical concepts for treating obstructive sleep apnea syndrom. J Oral Maxillofac Surg 45 : 149, 1987 https://doi.org/10.1016/0278-2391(87)90405-8
  13. Tagagi Y, Gambe JW, Proffit WR et al : Postural change of hyoid bone following osteotomy of mandible. Oral Surg Oral Med Oral Pathol 23 : 668, 1967
  14. Sang-han Lee : A study of relapse and position of hyoid bone following orthognathic surgery. J Kor Acad Maxillo Plas Reconstr Surg 13 : 8, 1991
  15. Dong-hee Chung, Ki-soo Lee : A study on changes of airway. tongue, and hyoid positioin following orthognathic surgery. Kor J Orthodontics 28 : 487, 1998
  16. Wenzel NA, Williams S, Ritzau M : Change in head position and nasopharygeal airway following surgical correction of mandibular prognathism. European J Orthod 11 : 37, 1989
  17. Jamieson A, Guilleminault C, Partinen M et al : Obstructive sleep apnetic patient have craniomandibular abnormalities. Sleep 9 : 469, 1986
  18. DePonte FS, Brunelli A, marchetti E : Cephalometric study of posterior airway space in patient affected by Class II occlusion and treated with orthognathic surgery. J Craniofac Surg 10 : 252, 1999 https://doi.org/10.1097/00001665-199905000-00014
  19. Hyo-yong Kim, Hyun-gue choi, Eun-kyung Kim : The effects of mandibular setback osteotomy on the orthopharyngeal airway space in mandibular prognathic patients. Kor J orthodontics 27 : 733. 1997