DOI QR코드

DOI QR Code

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

Comparison of the Change in the Pharyngeal Airway Space, Tongue and Hyoid Bone Positions according to the Orthognathic Surgical Methods of Mandibular Prognathism

  • 이윤선 (단국대학교 치과대학 구강악안면외과학교실) ;
  • 한세진 (단국대학교 치과대학 구강악안면외과학교실)
  • 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)
  • 투고 : 2013.02.25
  • 심사 : 2013.07.23
  • 발행 : 2013.07.31

초록

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.

키워드

참고문헌

  1. Lew KK. Changes in tongue and hyoid bone positions following anterior mandibular subapical osteotomy in patients with Class III malocclusion. Int J Adult Orthodon Orthognath Surg 1993;8:123-8.
  2. Rix RE. Some observations upon the environment of the incisors. Dent Rec 1953;73:427-41.
  3. Ballard CF. The etiology of malocclusion, an assessment. Dent Practit 1957;8:42.
  4. Greco JM, Frohberg U, Van Sickels JE. Long-term airway space changes after mandibular setback using bilateral sagittal split osteotomy. Int J Oral Maxillofac Surg 1990;19:103-5. https://doi.org/10.1016/S0901-5027(05)80204-8
  5. Athanasiou AE, Toutountzakis N, Mavreas D, Ritzau M, Wenzel A. Alterations of hyoid bone position and pharyngeal depth and their relationship after surgical correction of mandibular prognathism. Am J Orthod Dentofacial Orthop 1991;100:259-65. https://doi.org/10.1016/0889-5406(91)70063-3
  6. Wenzel A, Williams S, Ritzau M. Relationships of changes in craniofacial morphology, head posture, and nasopharyngeal airway size following mandibular osteotomy. Am J Orthod Dentofacial Orthop 1989;96:138-43. https://doi.org/10.1016/0889-5406(89)90254-0
  7. Riley RW, Powell NB, Guilleminault C, Ware W. Obstructive sleep apnea syndrome following surgery for mandibular prognathism. J Oral Maxillofac Surg 1987;45:450-2. https://doi.org/10.1016/0278-2391(87)90016-4
  8. Hochban W, Schürmann R, Brandenburg U, Conradt R. Mandibular setback for surgical correction of mandibular hyperplasia--does it provoke sleep-related breathing disorders? Int J Oral Maxillofac Surg 1996;25:333-8. https://doi.org/10.1016/S0901-5027(06)80024-X
  9. De Ponte FS, Brunelli A, Marchetti E, Bottini DJ. Cephalometric study of posterior airway space in patients affected by Class II occlusion and treated with orthognathic surgery. J Craniofac Surg 1999;10:252-9. https://doi.org/10.1097/00001665-199905000-00014
  10. Tselnik M, Pogrel MA. Assessment of the pharyngeal airway space after mandibular setback surgery. J Oral Maxillofac Surg 2000;58:282-5. https://doi.org/10.1016/S0278-2391(00)90053-3
  11. Marşan G, Cura N, Emekli U. Changes in pharyngeal (airway) morphology in Class III Turkish female patients after mandibular setback surgery. J Craniomaxillofac Surg 2008;36:341-5. https://doi.org/10.1016/j.jcms.2008.03.001
  12. Gu G, Gu G, Nagata J, et al. Hyoid position, pharyngeal airway and head posture in relation to relapse after the mandibular setback in skeletal Class III. Clin Orthod Res 2000;3:67-77. https://doi.org/10.1034/j.1600-0544.2000.030203.x
  13. Degerliyurt K, Ueki K, Hashiba Y, Marukawa K, Nakagawa K, Yamamoto E. A comparative CT evaluation of pharyngeal airway changes in class III patients receiving bimaxillary surgery or mandibular setback surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;105:495-502. https://doi.org/10.1016/j.tripleo.2007.11.012
  14. Chen F, Terada K, Hua Y, Saito I. Effects of bimaxillary surgery and mandibular setback surgery on pharyngeal airway measurements in patients with Class III skeletal deformities. Am J Orthod Dentofacial Orthop 2007;131:372-7. https://doi.org/10.1016/j.ajodo.2005.06.028
  15. Park HS, Bae JS, Kim KH, Park KH, Huh JK. Cephalometric study of posterior airway space and hyoid bone position in patients affected by class 2 malocclusion and treated with orthognathic surgery. J Korean Assoc Maxillofac Plast Reconstr Surg 2001;23:540-52.
  16. Enacar A, Aksoy AU, Sençift Y, Haydar B, Aras K. Changes in hypopharyngeal airway space and in tongue and hyoid bone positions following the surgical correction of mandibular prognathism. Int J Adult Orthodon Orthognath Surg 1994;9:285-90.
  17. Waite PD, Vilos GA. Surgical changes of posterior airway space in obstructive sleep apnea. Oral Maxillofac Surg Clin North Am 2002;14:385-99. https://doi.org/10.1016/S1042-3699(02)00033-X
  18. Stepovich ML. A cephalometric positional study of the hyoid bone. Am J Orthod 1965;51:882-900. https://doi.org/10.1016/0002-9416(65)90202-2
  19. Bibby RE, Preston CB. The hyoid triangle. Am J Orthod 1981;80:92-7. https://doi.org/10.1016/0002-9416(81)90199-8
  20. Takagi Y, Gamble JW, Proffit WR, Christiansen RL. Postural change of the hyoid bone following osteotomy of the mandible. Oral Surg Oral Med Oral Pathol 1967;23:688-92. https://doi.org/10.1016/0030-4220(67)90352-0
  21. Wickwire NA, White RP Jr, Proffit WR. The effect of mandibular osteotomy on tongue position. J Oral Surg 1972;30:184-90.
  22. Lee SH. A study of relapse and position of hyoid bone following orthognathic surgery. J Korean Assoc Maxillofac Plast Reconstr Surg 1991;13:476-90.
  23. Park JW, Lee ET, Min SK, Lee DK. Stability of two-jaw surgery and single mandibular surgery in mandibular prognathism. J Korean Assoc Maxillofac Plast Reconstr Surg 2002;24:406-14.
  24. Ive J, McNeill RW, West RA. Mandibular advancement: skeletal and dental changes during fixation. J Oral Surg 1977;35:881-6.

피인용 문헌

  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