Pharyngeal airway changes five years after bimaxillary surgery – A retrospective study

• Published in: Journal of cranio-maxillo-facial surgery Vol. 50; no. 11; pp. 848 - 857
• Main Authors: Madhan, Sivaranjani, Holte, Michael Boelstoft, Diaconu, Alexandru, Thorn, Jens Jørgen, Ingerslev, Janne, Nascimento, Gustavo G., Cornelis, Marie, Pinholt, Else Marie, Cattaneo, Paolo M.
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.11.2022
• Subjects: Adult; Cephalometry - methods; Computer-assisted surgery; Cone-beam computed tomography; Cone-Beam Computed Tomography - methods; Female; Humans; Male; Malocclusion, Angle Class III - surgery; Mandible - diagnostic imaging; Mandible - surgery; Orthognathic surgery; Orthognathic Surgical Procedures - methods; Pharynx; Pharynx - diagnostic imaging; Retrospective Studies; Three-dimensional imaging; Orthognathic surgery; Cone-beam computed tomography; Pharynx; Three-dimensional imaging; Computer-assisted surgery
• ISSN: 1010-5182; 1878-4119; 1878-4119
• DOI: 10.1016/j.jcms.2022.09.009

The aim of this study was to retrospectively evaluate pharyngeal airway (PA) changes after bimaxillary surgery (BMS). Preoperative, immediate- and 5-year postoperative cone-beam computed tomography images of subjects who underwent BMS were assessed. The primary outcome variable was the PA volume. The secondary outcome variables were the retropalatal and oropharyngeal volumes, cross-sectional area, minimal hydraulic diameter, soft tissue, skeletal movements and sleep-disordered breathing (SDB). A total of 50 patients were included, 33 female and 17 male, with a mean age of 26.5 years. A significant increase in the PA volume was seen immediately after surgery (40%), and this increase was still present at 5-year follow-up (34%) (P < 0.001). A linear mixed model regression analysis revealed that a mandibular advancement of ≥5 mm (P = 0.025) and every 1-mm upward movement of epiglottis (P = 0.016) was associated with a volume increase of the oropharyngeal compartment. Moreover, ≥5-mm upward movement of hyoid bone (P = 0.034) and every 1-mm increase in minimal hydraulic diameter (P < 0.001) correlated with an increase of the PA volume. A total of 30 subjects reported improvement in the SDB at 5-year follow-up. This study demonstrated that BMS led to an increase in PA dimensions in non-OSA patients, and these changes were still present at 5-year follow-up. BMS seemed to induce clinical improvement in SDB.