• Maxillofacial Plastic and Reconstructive Surgery
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• v.14 no.1_2
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• pp.1-21
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• 1992

In order to find the causes of velopharyngeal incompetency after primary palatorrhaphy in cleft patients, we analyzed the form and function of the velopharyngeal space of fifteen operated cleft palate patients and five normal subjects. The velopharyngeal function was evaluated by lateral cephalometric radiography, velopharyngography and hypernasality cul-de-sac test. The obtained results were as follows. 1. The rate of velopharyngeal incompetency was twenty percent, three of the fifteen operated patients. Two of them were complete cleft palate and the other was incomplete one. 2. The length of soft palate and levator eminence were longer in normal group than those of good speech group and complete cleft palate group during phonation of /i/ (P<0.05). The lengthening rate of soft palate was smaller in good and poor speech group than that of normal group(P<0.05), and, reduced in order, normal group, complete cleft palate group and incomplete palate group(P<0.05). 3. The nasopharyngeal distance had no significant difference between all groups at rest, but, smaller in normal group than that of both cleft palate group(P<0.05), good speech group and poor speech group(P<0.05) during phonation of /i/ The difference in nasopharyngeal distance between rest and /i/ phonation was greater in normal group than that of both cleft palate group, good speech group and poor speech group. 4. The moving distance of sop palate reduced in order, normal group, incomplete cleft palate group, complete cleft palate group(P<0.05). 5. The distance between lateral pharyngeal wall had no significant difference between all groups in rest, but, smaller than that of complete cleft palate group in normal group(P<0.01) and increased in order normal group, good speech group, poor speech group(P<0.01) during phonation of /a/. The mobility of lateral wall was reduced in order, normal group, good speech group poor speech group(P<0. 01). 6. There was low corelationship between the mobility of lateral pharyngeal wall and soft palate. Therfore, it suggest that the movements of lateral pharyngeal wall and soft palate occurs independently.

• The korean journal of orthodontics
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• v.50 no.4
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• pp.238-248
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• 2020

Objective: To investigate the effects of the long-term use of a maxillary protraction facemask with miniplate (FM-MP) on pharyngeal airway dimensions in growing patients with cleft lip and palate (CLP). Methods: The study included 24 boys with CLP (mean age, 12.2 years; mean duration of FM-MP therapy, 4.9 years), divided into two groups according to the amount of A point advancement to the vertical reference plane (VRP): Group 1, > 4 mm; Group 2, < 2 mm; n = 12/group. After evaluating the skeletodental and airway variables using lateral cephalograms acquired before and after FM-MP therapy, statistical analyses were performed. Results: Group 1 showed greater forward and downward displacements of the posterior maxilla (posterior nasal spine [PNS]-horizontal reference plane [HRP]; PNS-VRP), greater increase in ANB, more forward tongue position (tongue tip-Pt vertical line to Frankfort horizontal plane), and greater increase in the oropharynx (superior posterior airway space [SPAS]; middle airway space [MAS]) and upper nasopharynx (PNS-adenoid2) than did Group 2. While maxillary advancement (A-VRP and PNS-VRP) correlated with increases in SPAS, MAS, and PNS-adenoid2, downward displacement of the PNS (PNS-HRP) correlated with increases in SPAS, MAS, PNS-adenoid1, and PNS-adenoid2, and with a decrease in vertical airway length (VAL). Mandibular forward displacement and decrease in mandibular plane correlated with increases in MAS. Conclusions: FM-MP therapy had positive effects on the oropharyngeal and nasopharyngeal airway spaces without increases in VAL in Group 1 rather than in Group 2. However, further validation using an untreated control group is necessary.

• 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.23 no.1
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• pp.7-14
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• 2001

Purpose : The lateral cephalometric Korean norms of the skeletal and pharyngeal dimension were analyzed for the diagnosis of obstructive sleep apnea syndrome(OSAS). Materials and Methods : The lateral cephalometric radiographies were taken in male(n=53) and female(n=50), who had a normal profile, class I occlusion, normal ANB $(0{\sim}4^{\circ})$ and normal Wits $Appraisal(-4{\sim}0mm)$. The X-rays were traced by two oral and maxillofacial surgeons twice. The significant differences between male-female and examiners were tested. Results : The angle of mandibular line to Nasion-Sella line was $31.12^{\circ}/33.79^{\circ}$ (in male/in female, p=0.0018). The lower Gonion angle was $73.74^{\circ}/73.74^{\circ}(p=0.9978)$. The length of the soft palate was 36.93mm/34.35mm(p=0.0002). The pharyngeal airway space was 13.42mm/11.55mm at mandibular plane level(PAS(ML))(p=0.0025). The hyoid was placed inferiorly to mandibular plane 10.18mm/7.72mm(p=0.0051). The results from this study are to be used for the diagnosis of OSAS.

• Journal of Oral Medicine and Pain
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• v.34 no.3
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• pp.247-256
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• 2009

The purpose of this study was to investigate the changes of the pharyngeal space when the following appliances were inserted: the mandibular advancement appliance (MAA), tongue retaining appliance (TRA), and mandibular advancement-tongue retaining appliance (MATRA). Nine male dental students exhibiting Class I occlusion, normal body mass index (BMI), and no signs and symptoms of snoring were selected for this study. The three kinds of snoring appliances (MAA, TRA and MATRA) were fabricated for each subject. The mandibular advancement of the MAA and MATRA was set at a distance of 5 mm, and the TRA and MATRA were made to hold the tongue in front of the maxillary incisors by 10 to 20 mm. Lateral cephalometric radiographs of the following four states - with no appliance, MAA, TRA, and MATRA - were taken to examine any anatomical changes resulting from the application of the appliances. All four radiographs were traced and analyzed for twenty selected variables related to the pharyngeal space, cranio-cervical posture, and position of the soft palate and hyoid bone. According to the results of this study, there were significant increases in both the upper and lower oropharyngeal spaces when the mandible and tongue were protruded simultaneously, although there was a significant increase only in upper oropharyngeal space when the mandible or tongue was advanced separately. In conclusion, it is suggested that the MATRA may result in more positive effect on the control of snoring and OSA compared to a single use of the MAA or TRA, especially for the patients whose upper airway obstruction occurs in the lower oropharynx.

• Imaging Science in Dentistry
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• v.47 no.1
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• pp.1-9
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• 2017

Purpose: This retrospective study aimed to evaluate the nasopharyngeal and oropharyngeal dimensions of individuals with skeletal class II, division 1 and division 2 patterns during the pre-peak, peak, and post-peak growth periods for comparison with a skeletal class I control group. Materials and Methods: Totally 124 lateral cephalograms (47 for skeletal class I; 45 for skeletal class II, division 1; and 32 for skeletal class II, division 2) in pre-peak, peak, and post-peak growth periods were selected from the department archives. Thirteen landmarks, 4 angular and 4 linear measurements, and 4 proportional calculations were obtained. The ANOVA and Duncan test were applied to compare the differences among the study groups during the growth periods. Results: Statistically significant differences were found between the skeletal class II, division 2 group and other groups for the gonion-gnathion/sella-nasion angle. The sella-nasion-B-point angle was different among the groups, while the A-point-nasion-B-point angle was significantly different for all 3 groups. The nasopharyngeal airway space showed a statistically significant difference among the groups throughout the growth periods. The interaction among the growth periods and study groups was statistically significant regarding the upper oropharyngeal airway space measurement. The lower oropharyngeal airway space measurement showed a statistically significant difference among the groups, with the smallest dimension observed in the skeletal class II, division 2 group. Conclusion: The naso-oropharyngeal airway dimensions showed a statistically significant difference among the class II, division 1; class II, division 2; and class I groups during different growth periods.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.1
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• pp.98-108
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• 2018

This study aimed to evaluate the nasopharyngeal and oropharyngeal dimensions of the patients with skeletal class II division 1 or division 2 patterns during the pre-peak, peak, and post-peak growth periods for comparison with a skeletal class I control group (79 for pre-peak, 40 for peak, 40 for post-peak). Total 159 lateral cephalograms (70 for skeletal class I, 51 for skeletal class II, division 1, and 38 for skeletal class II, division 2) were selected. The growth of anteroposterior dimension of the pharyngeal airway were statistically significant among growth periods. The dimension for the nasopharyngeal and oropharyngeal airway space was the smallest in the division 1 skeletal class II group followed by class II division 2 and skeletal class I.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.4
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• pp.211-220
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• 2013

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.

• The korean journal of orthodontics
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• v.40 no.3
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• pp.145-155
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• 2010

Objective: Lateral cephalometric radiographs have been the main form of resource for assessing two dimensional anteroposterior airway changes. The purpose of this study was to evaluate the three dimensional volumetric change in the upper airway space in Class III malocclusion patients who underwent mandibular setback surgery. Methods: Three dimensional cone-beam computed tomographs (CBCT) and their three dimensional reconstruction images were analyzed. The samples consisted of 20 adult patients (12 males and 8 females) who were diagnosed as skeletal Class III and underwent mandibular setback surgery. CBCTs were taken at 3 stages - Baseline (1.8 weeks before surgery), T1 (2.3 months after surgery), and T2 (1 year after surgery). Pharyngeal airway was separated according to the reference planes and reconstructed into the nasopharynx, the oropharynx and the hypopharynx. Measurements at Baseline, T1, and T2 were compared between groups. Results: The result showed the volume of the pharyngeal airway decreased significantly 2.3 months after surgery (p < 0.001) and the diminished airway did not recover after 1 year post-surgery. The oropharynx was the most decreased area. Conclusions: These findings suggest that mandibular setback surgery causes both short-term and long-term decrease in the upper airway space.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.4
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• pp.314-319
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• 2010

Odontogenic infections are a normally locally confined, self-limiting process that is easily treated by antibiotic therapy and local surgical treatment. However, it may spread into the surrounding tissues through a perforation of the bone, and into contiguous fascial spaces or planes like the primary or secondary fascial spaces. If the infection extends widely, it may spread into the lateral pharyngeal and retropharyngeal space. The retropharyngeal space is located posterior to the pharynx. If an odontogenic infection spreads into this space, severe life-threatening complications will occur, such as airway obstruction, mediastinitis, pericarditis, pleurisy, pulmonary abscess, aspiration pneumonia and hematogenous dissemination to the distant organs. The mortality rate of mediastinitis ranges from 35% to 50%. Therefore, a rapid evaluation and treatment are essential for treating retropharyngeal space abscesses and preventing severe complications. Recently, we encountered two cases of a retropharyngeal space abscess due to the spread of an odontogenic infection. In all patients, early diagnosis was performed by computed tomography scanning and a physical examination. All patients were treated successfully by extensive surgical and antibiotic therapy.