Maxillofacial Plastic and Reconstructive Surgery

Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
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Comparison of the Change in the Pharyngeal Airway Space, Tongue and Hyoid Bone Positions according to the Orthognathic Surgical Methods of Mandibular Prognathism

하악 전돌증 환자에서 악교정 수술방법에 따른 설골과 혀의 위치 및 기도량 변화의 비교

  • Lee, Yoon-Sun (Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University) ;
  • Han, Se-Jin (Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University)
  • 이윤선 (단국대학교 치과대학 구강악안면외과학교실) ;
  • 한세진 (단국대학교 치과대학 구강악안면외과학교실)
  • Received : 2013.02.25
  • Accepted : 2013.07.23
  • Published : 2013.07.31
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Abstract

Purpose: The purpose of this study was to compare the changes in the pharyngeal airway space, tongue and hyoid bone positions according to the orthognathic surgical methods of mandibular prognathism. Methods: The subjects included 30 patients (16 males, 14 females) with the skeletal class III malocclusion. Group 1 (10 patients) underwent bilateral sagittal split ramus osteotomy (BSSRO) only; group 2 (10 patients) underwent BSSRO with genioplasty; and group 3 (10 patients) underwent BSSRO, Le Fort I osteotomy. We measured the lines between the selected upper air way, hyoid bone and tongue landmarks on the lateral cephalometric x-ray films of skeletal class III. The measurements were made preoperation, within 1 week after the operation, 3~6 months after the operation and 1 year after the operation. We compared and analyzed the measurements with matched paired t-test and independent samples t-test. Results: There were no postoperative changes in the nasopharyngeal airway space in group 3. The measurements of group 3 also increased during the follow-up period as compared to the preoperative measurements. In group 1, 2 and 3, the immediate postoperative oropharyngeal and hypopharyngeal airway spaces were decreased. In the following period, the hypopharyngeal airway space returned to the preoperative positions, but the oropharyngeal airway space was not significantly changed. The upper and lower tongue was posteriorly repositioned immediately after the surgery. During the follow-up period, the lower tongue position returned to the preoperative position, and the upper tongue position was not significantly changed. Immediately after the surgery, the B point was moved to the posterior position, and a slight anterior advancement was found in the follow-up period. Conclusion: Patients who received the mandibular setback surgery showed a decrease in the posterior airway space, and those who underwent maxillary advancement showed a significant increase of the nasopharyngeal airway space, which remained stable during the evaluation period. The change of the airway space, position of the hyoid bone and tongue did not differ according to the presence or absence of genioplasty.

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  1. Changes of airway after orthognathic surgery for patients with skeletal class III malocclusion vol.18, pp.4, 2013, https://doi.org/10.13065/jksdh.20180048