Abstract
The objective of the present study was to evaluate the relation between mandibular
advancement, the three-dimensional extent of the posterior airway space (PAS), and
the position of the hyoid bone, using cone-beam computed tomography (CT). Twenty-eight
Class II patients (21 women (mean (SD) age 29 (9) years) and seven men (mean (SD)
age 23 (6) years)), who had had mandibular-only advancement surgery (Obwegeser-Dal
Pont) were included in the study. In each case, cone-beam CT scans were taken one
week before and six months after operation, and a retrospective analysis made of the
alterations of several airway variables (volume, mean cross-sectional area, and diameter)
and the three-dimensional extent of mandibular and hyoid movement, by using IPlan®
cranial software. A linear regression was also done to correlate mandibular advancement,
the movement of the hyoid bone, and airway variables. There were significant postoperative
increases in all volumetric PAS variables, and in most diametric and spherical variables
(p < 0.05). There was also a significant linear relation between forward displacement of
the mandible and the movement of the hyoid bone (p < 0.05). These results show that mandible-only advancement surgery causes an increase
in most dimensions of the PAS. This intervention can be assumed to reduce airway resistance
and therefore might be a suitable treatment option for patients with obstructive sleep
apnoea syndrome.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to British Journal of Oral and Maxillofacial SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Positional therapy for obstructive sleep apnoea.Cochrane Database Syst Rev. 2019; 5CD010990
- Obstructive sleep apnea syndrome: An important piece in the puzzle of cardiovascular risk factors.Clin Investig Arterioscler. 2015; 27: 256-263
- Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medicine Clinical Practice Guideline.J Clin Sleep Med. 2017; 13: 479-504
- Obstructive sleep apnea hypopnea syndrome.Ann Med Health Sci Res. 2012; 2: 74-77
- Cephalometric and computed tomographic predictors of obstructive sleep apnea severity.Am J Orthod Dentofacial Orthop. 1995; 107: 589-595
- A cephalometric comparison of patients with the sleep apnea/hypopnea syndrome and their siblings.Sleep. 2005; 28: 315-320
- Craniofacial abnormalities in obstructive sleep apnoea: Implications for treatment.Respirology. 1996; 1: 167-174
- Continuous positive airways pressure for obstructive sleep apnoea in adults.Cochrane Database Syst Rev. 2006; 1CD001106
- Surgery for obstructive sleep apnoea.Cochrane Database Syst Rev. 2005; 4CD001004
- Maxillomandibular advancement as surgical treatment for obstructive sleep apnea in active duty military personnel: a retrospective cohort.Mil Med. 2012; 177: 1387-1392
- Effectiveness of maxillo-mandibular advancement in obstructive sleep apnea patients with and without skeletal anomalies.Int J Oral Maxillofac Surg. 2010; 39: 541-547
- Long-term results of maxillomandibular advancement surgery in patients with obstructive sleep apnoea syndrome.Br J Oral Maxillofac Surg. 2013; 51: e37-e39
- Short- and long-term changes of the pharyngeal airway after surgical mandibular advancement in Class II patients-a three-dimensional retrospective study.J Craniomaxillofac Surg. 2018; 46: 56-62
- The effects of orthognathic surgery on pharyngeal airway dimensions and quality of sleep.J Orthod. 2000; 27: 235-247
- Retro-molar osteotomy for correction of prognathism.Minerva Chir. 1959; 14 (paper in Italian): 1138-1141
- Effect of occlusal plane correction on lip cant in two-jaw orthognathic surgery - A three-dimensional analysis.J Craniomaxillofac Surg. 2017; 45: 1026-1030
- Short-term pharyngeal airway changes after mandibular advancement surgery in adult class II-patients—a three-dimensional retrospective study.J Orofac Orthop. 2013; 74: 137-152
- Effect of mono- and bimaxillary advancement on pharyngeal airway volume: cone-beam computed tomography evaluation.J Oral Maxillofac Surg. 2011; 69: e395-e400
- Long-term influence of mandibular advancement on the volume of the posterior airway in skeletal Class II-patients: A retrospective analysis.Br J Oral Maxillofac Surg. 2017; 55: 780-786
- Three-dimensional computed tomographic airway analysis of patients with obstructive sleep apnea treated by maxillomandibular advancement.J Oral Maxillofac Surg. 2011; 69: 677-686
- A 2-year follow-up of changes after bimaxillary surgery in patients with mandibular prognathism: 3-dimensional analysis of Pharyngeal airway volume and hyoid bone position.J Oral Maxillofac Surg. 2015; 73: e1-e9
Schulze R, Deppe H, Betz W, et al. German S2k-Guidelines for Dental Cone beam computed tomography (Document in German). Available from URL: http://www.dgzmk.de/uploads/tx_szdgzmkdocuments/083- Last accessed 1 September 2019.
- Head posture and pharyngeal airway volume changes after bimaxillary surgery for mandibular prognathism.J Craniomaxillofac Surg. 2014; 42: 531-535
- The effect of head posture on the pharyngeal airway space (PAS).Int J Oral Maxillofac Surg. 2002; 31: 579-583
- Head posture and hyo-mandibular function in man. A synchronized electromyographic and videofluorographic study of the open-close-clench cycle.Am J Orthod Dentofacial Orthop. 1988; 94: 393-404
- Positional changes of oropharyngeal structures due to gravity in the upright and supine positions.Dentomaxillofac Radiol. 2008; 37: 130-135
Article Info
Publication History
Published online: September 26, 2019
Accepted:
September 2,
2019
Identification
Copyright
© 2019 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
