Three-dimensional analysis of changes in airway space after bimaxillary orthognathic surgery with maxillomandibular setback and their association with obstructive sleep apnea

• Published in: Maxillofacial plastic and reconstructive surgery Vol. 40; no. 1; p. 33
• Main Authors: Jang, Seung-Il, Ahn, Jaemyung, Paeng, Jun Young, Hong, Jongrak
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2018; SpringerOpen; 대한악안면성형재건외과학회
• Subjects: Airway space; Apnea-Hypopnea Index; Bimaxillary orthognathic surgery; Dentistry; Mandibular setback; Maxillary setback; Maxillomandibular setback; Medicine; Oral and Maxillofacial Surgery; Plastic Surgery; 치의학; Bimaxillary orthognathic surgery; Mandibular setback; Apnea-Hypopnea Index; Maxillary setback; Maxillomandibular setback; Airway space
• DOI: 10.1186/s40902-018-0171-3
• ISSN: 2288-8101; 2288-8586

Background Bimaxillary orthognathic surgery with maxillomandibular setback is often accompanied by changes in airway space. We analyzed the changes in airway space before and after surgery and assessed their association with obstructive sleep apnea. Methods This study is based on the cohort of 13 adult patients (9 males, 4 females, average age 23.85 years) who underwent bimaxillary orthognathic surgery with maxillomandibular setback. We performed computed tomography and portable polysomnography before and after the surgery to assess changes in airway space and Apnea-Hypopnea Index (AHI) values (total, supine, non-supine). Results The oropharyngeal airway volume decreased by 29% after the surgery, which was statistically significant ( p  < .05). The upper airway volume and hypopharyngeal airway volume were decreased, but not significantly (4 and 19%, respectively). The changes in airway surface area were statistically significant at all levels examined ( p  < .05). Changes in the maximum anteroposterior width of the airway were also significant at all levels ( p  < .05). However, the changes in maximum lateral width were only statistically significant at C2 level ( p  < .05). AHI values were increased after the surgery but not significantly at any position. Conclusions Although bimaxillary surgery with maxillomandibular setback significantly reduces the airway space, it does not affect AHI values or induce obstructive sleep apnea.