• The korean journal of orthodontics
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• v.26 no.1 s.54
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• pp.43-52
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• 1996

The purpose of this study was to compare and evaluate the upper airway structure between the snorers and asymptomatic control subjects depending on the positional change. Lateral cephalograms in the upright and supine position were taken in 25 female snorers and 20 female asymptomatic control subjects. The length and the area of the soft palate, tongue and airway were measured and evaluated statistically. The results obtained were as follows : 1. The snorers showed longer and higher tongue, narrower and longer airway, inferiorly positioned hyoid bone, longer and broader soft palate and narrower hypopharynx than the control subjects both in the upright and supine position. In addition, the snorers showed broader tongue area and narrower oropharynx area than the control subjects in supine position. 2. Depending on the positional change from upright to supine position, the controls and the snorers showed decreased airway length and superior positioned the hyoid bone. In addition, the snorers showed decreased tongue length and height, airway length and thickness and oropharynx area, but increased tongue area and soft palate area.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.3
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• pp.307-313
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• 2018

The respiratory function is relevant to the craniofacial growth and orthodontic diagnosis. The size of the pharyngeal airway was measured in lateral cephalometric view in children visited Kyung Hee University Hospital from January 2015 to August 2017. A total of 74 healthy children (36 boys and 38 girls) aged 7 - 11 years (mean, 8.5 years) with a normodivergent facial pattern were divided into three groups according to anteroposterior jaw relation measuring A point-Nasion-B point (ANB) angle. Lateral cephalometric data were used to measure the airway dimensions. The dimensions of the middle airway were significantly lower, reducing the upper airway space, in large ANB angle group than in other children, suggesting that children with large ANB angle have narrower airway space than others.

• Journal of Chest Surgery
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• v.47 no.3
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• pp.313-316
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• 2014

Airway obstruction after esophageal surgery is quite rare, and few such cases have been reported. A 57-year-old woman who underwent the Ivor Lewis procedure for esophageal carcinoma complained of a sudden onset of severe dyspnea on postoperative day 3. Chest computed tomography scan revealed that the collection of a large volume of mediastinal fluid caused marked luminal compression on the trachea and the gastric conduit. Explorative thoracotomy revealed a clear serous fluid in the space between the trachea and the gastric conduit, and all respiratory symptoms were relieved after the fluid was drained. The possibility of tracheal compression by loculated effusion, such as chyloma, should be considered in a patient who complains of respiratory deterioration after esophageal surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.38 no.1
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• pp.9-13
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• 2012

Introduction: To evaluate the 3-dimensional changes in the pharyngeal airway of skeletal class III patients after bimaxillary surgery. Materials and Methods: The study sample consisted of 18 Korean patients that had undergone maxillary setback or posterosuperior movement and mandibular bilateral sagittal split osteotomy setback surgery due to skeletal class III malocclusion (8 males, 10 females; mean age of 28.7). Cone beam computed tomography was taken 1 month before and 6 months after orthognathic surgery. Preoperative and postoperative volumes of the nasopharyngeal, oropharyngeal, and laryngopharyngeal airways and minimum axial areas of the oropharyngeal and laryngopharyngeal spaces were measured. Moreover, the pharyngeal airway volume of the patient group that had received genioplasty advancement was compared with the other group that had not. Results: The nasopharyngeal and laryngopharyngeal spaces did not show significant differences before or after surgery. However, the oropharyngeal space volume and total volume of pharyngeal airway decreased significantly (P<0.05). The minimum axial area of the oropharynx also decreased significantly. Conclusion: The results indicate that bimaxillary surgery decreased the volume and the minimum axial area of the oropharyngeal space. Advanced genioplasty did not seem to have a significant effect on the volumes of the oropharyngeal and laryngopharyngeal spaces.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.51.1-51.8
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• 2019

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.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.38 no.5
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• pp.295-304
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• 2012

Objectives: Lateral cephalometry, computed tomography (CT) and full-night polysomnography were used to examine the correlation of obstructive sleep apnea (OSA) severity. Materials and Methods: A total of 29 patients (5 females, 24 males) diagnosed with OSA were evaluated by lateral cephalometry, CT and full-night polysomnography. Lateral cephalometry was performed in the closed and open mouth states. The radiographic and polysomnography measurements of the patients with OSA were evaluated statistically to determine the association with OSA severity. Results: A significant relationship was observed between the increased respiratory disturbance index and closing lateral cephalometry. With mouth opening, the airway space narrowed and the OSA worsened. Lateral cephalometry revealed OSA patients to have an inferiorly positioned hyoid bone, longer-than-normal soft palate and narrowing airway space. As OSA was severe, the airway shape was ovoid in the CT horizontal view. Conclusion: Polysomnography and the radiographic parameter can be used for diagnosing OSA.

• Journal of Oral Medicine and Pain
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• v.23 no.1
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• pp.75-84
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• 1998

The Purpose of this Study was to examine the anatomic differences in the upper airway according to severity of respiratory disturbance index of habitual snorers. Forty-three male habitual snorers, aged 28-68, were examined by polysomnography and divided into 4 groups according to severity determined by polysomnography. Anatomic differences in the upper airway were assessed by lateral cephalograms in upright position, and epidemiological surveys were done by using questionnaires. The obtained results were as follows : 1. All subjects were habitual snorers and 35 patients (81.4%) complained the loudness of snoring as severe as be heard outside of the room. 2. According to the results of polysomnography, the number of the primary snoring patients was 7(16.3%), mild obtrusive sleep apnea 7(16.3%), moderate 7(16.3%), and severe 22(51.2%). 3. The respiratory disturbance index (RDI) of subjects was 39.5$\pm$24.4 and the body mass index(BMI) was 26.2$\pm$2. 4. More inferiorly positioned hyoid bone according to the degree of respiratory disturbace index (RDI) was observed. (p<0.001) 5. The width of superior oropharyngeal airway space was according to the degree of RDI. (p<0.001)

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.1
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• pp.36-43
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• 2011

Purpose: This study evaluated the pharyngeal airway space changes in CT images in patients receiving bilateral sagittal split osteotomy (BSSRO) for the surgical correction of mandibular prognathism. Methods: A total of 22 patients with mandibular prognathism were treated using BSSRO. Computed tomography was performed 1 month (T0) before surgery and, 1 month after surgery (T1). The anteroposterior length (AP), lateral width (LAT) and cross-sectional area (AREA) at the level of soft palate (C2) and base of the tongue (C3) were measured using CT images. Results: The mean amount of mandibular setback was 7.41 mm (${\pm}$3.46 mm). All the AP, LAT and AREA at the C2 and C3 level were decreased significantly 1 month after surgery (P<0.001). As the amount of mandibular setback was increased, the AP, LAT and AREA levels at the level of C2 and C3 had decreased. In addition, the reduction of the AREA at the C3 level was associated with the amount of mandibular setback (P<0.05). Conclusion: A significant decrease in pharyngeal airway space was observed 1 month after the operation. The cross-sectional area at the level of base of tongue was decreased with increasing amount of mandibular setback.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.6
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• pp.552-558
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• 2005

Orthognathic surgery changes patient's mandibular position and environment of related anatomic structures. Many clinicians were interested in these changes and studied about this problem. However, most of them were based on two dimensional cephalogram. According to the development of image and computer system, it would be possible that the airway change is analyzed with three dimensional CT. So we tried to measure the volumetric change of airway and analyzed the relationship between the airway structure and volumetric change. Nineteen patients who experienced orthognathic surgery due to mandibular prognathism were analyzed with 3D CT data (preoperative and postoperative 6 months) and 2D lateral cephalometry. Volumetric change was measured and 3 dimensional change of related structure was assessed with simulation program ($V-works^{(R)}$, 4.0 Cybermed, Korea). Ten patients showed the decrease of airway volume change and nine showed the increase of airway volume change. Volumetric change was determined by dimensional change of mandible and hyoid bone. The dimensional positions of mandible and hyoid bone were the key factor for determining the airway change after surgery. Airway change is also predictable with the dimensional change of mandible and hyoid bone.

• The Korean Journal of Physiology and Pharmacology
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• v.19 no.1
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• pp.65-71
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• 2015

Asthma is a chronic inflammatory disease characterized by airway hyperresponsiveness (AHR) and reversible airway obstruction. Methacholine (MCh) is widely used in broncho-provocation test to evaluate airway resistance. For experimental investigation, ovalbumin-induced sensitization is frequently used in rodents (Ova-asthma). However, albeit the inflammatory histology and AHR in vivo, it remains unclear whether the MCh sensitivity of airway smooth muscle isolated from Ova-asthma is persistently changed. In this study, the contractions of airways in precision-cut lung slices (PCLS) from control, Ova-asthma, and IL-13 overexpressed transgenic mice (IL-13TG) were compared by analyzing the airway lumen space (AW). The airway resistance in vivo was measured using plethysmograph. AHR and increased inflammatory cells in BAL fluid were confirmed in Ova-asthma and IL-13TG mice. In the PCLS from all three groups, MCh concentration-dependent narrowing of airway lumen (${\Delta}AW$) was observed. In contrast to the AHR in vivo, the $EC_{50}$ of MCh for ${\Delta}AW$ from Ova-asthma and IL-13TG were not different from control, indicating unchanged sensitivity to MCh. Although the AW recovery upon MCh-washout showed sluggish tendency in Ova-asthma, the change was also statistically insignificant. Membrane depolarization-induced ${\Delta}AW$ by 60 mM $K^+$ (60K-contraction) was larger in IL-13TG than control, whereas 60K-contraction of Ova-asthma was unaffected. Furthermore, serotonin-induced ${\Delta}AW$ of Ova-asthma was smaller than control and IL-13TG. Taken together, the AHR in Ova-asthma and IL-13TG are not reflected in the contractility of isolated airways from PCLS. The AHR of the model animals seems to require intrinsic agonists or inflammatory microenvironment that is washable during tissue preparation.