Maxillofac Plast Reconstr Surg.  2019 ;41(1):51. 10.1186/s40902-019-0230-4.

Change of the upper airway after mandibular setback surgery in patients with mandibular prognathism and anterior open bite

• Lee K
• Hwang SJ

• KMID: 2468998
• DOI: http://doi.org/10.1186/s40902-019-0230-4

Abstract

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.

Keyword

Mandibular setback; Pharyngeal airway space; Mandibular prognathism; Open-bite; Hyoid bone

MeSH Terms

Humans
Hyoid Bone
Open Bite*
Orthognathic Surgery
Overbite
Prognathism*
Surgeons