Retrospective study on change in pharyngeal airway space and hyoid bone position after mandibular setback surgery
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objectives: The purpose of this study was to evaluate changes in the pharyngeal airway space and hyoid bone position after mandibular setback sur-gery with bilateral sagittal split ramus osteotomy (BSSRO) and to analyze the correlation between the amount of mandibular setback and the amount of change in pharyngeal airway space or hyoid bone position. Materials and Methods: From January 2010 to February 2013, a total of 30 patients who were diagnosed with skeletal class III malocclusion and underwent the same surgery (BSSRO) and fixationmethod in the Division of Oral and Maxillofacial Surgery, Department of Dentistry at the Ajou University School of Medicine (Suwon, Korea) were included in this study. Lateral cephalograms of the 30 patients were assessed preoperatively (T1), immediately postoperatively (T2), and 6 months postoperatively (T3) to investigate the significanceof changes by time and the correlation between the amount of mandibular setback and the amount of change in the airway space and hyoid bone position. Results: Three regions of the nasopharynx, oropharynx, and hypopharynx were measured and only the oropharynx showed a statistically significantdecrease (P<0.01). A significantposterior and inferior displacement of the hyoid bone was found 6 months after surgery (P<0.01). Analysis of the cor-relation between the amount of mandibular setback and the amount of finalchange in the airway space and hyoid bone position with Pearson’s correla-tion showed no significant correlation.Conclusion: In this study, the oropharynx significantlydecreased after mandibular setback surgery, and changes in the surrounding structures were identifiedthrough posteroinferior movement of the hyoid bone during long-term follow-up. Therefore, postoperative obstructive sleep apnea should be considered in patients who plan to undergo mandibular setback surgery, and necessary modifications to the treatment plan should alsobe considered.
Abstract
Objectives: The purpose of this study was to evaluate changes in the pharyngeal airway space and hyoid bone position after mandibular setback sur-gery with bilateral sagittal split ramus osteotomy (BSSRO) and to analyze the correlation between the amount of mandibular setback and the amount of change in pharyngeal airway space or hyoid bone position. Materials and Methods: From January 2010 to February 2013, a total of 30 patients who were diagnosed with skeletal class III malocclusion and underwent the same surgery (BSSRO) and fixationmethod in the Division of Oral and Maxillofacial Surgery, Department of Dentistry at the Ajou University School of Medicine (Suwon, Korea) were included in this study. Lateral cephalograms of the 30 patients were assessed preoperatively (T1), immediately postoperatively (T2), and 6 months postoperatively (T3) to investigate the significanceof changes by time and the correlation between the amount of mandibular setback and the amount of change in the airway space and hyoid bone position. Results: Three regions of the nasopharynx, oropharynx, and hypopharynx were measured and only the oropharynx showed a statistically significantdecrease (P<0.01). A significantposterior and inferior displacement of the hyoid bone was found 6 months after surgery (P<0.01). Analysis of the cor-relation between the amount of mandibular setback and the amount of finalchange in the airway space and hyoid bone position with Pearson’s correla-tion showed no significant correlation.Conclusion: In this study, the oropharynx significantlydecreased after mandibular setback surgery, and changes in the surrounding structures were identifiedthrough posteroinferior movement of the hyoid bone during long-term follow-up. Therefore, postoperative obstructive sleep apnea should be considered in patients who plan to undergo mandibular setback surgery, and necessary modifications to the treatment plan should alsobe considered.
참고문헌 (24)
- Athanasiou AE, "Alterations of hyoid bone position and pharyngeal depth and their relationship after surgical correction of mandibular prognathism", Am J Orthod Dentofacial Orthop, 100, pp.259~265 (1991)
- Lee DK, "Study on the changes in the upper airway following osteotomy for the mandibular prognathism", J Korean Dent Assoc, 27, pp.1143~1153 (1989)
- Chin KS, "The relationships between the postoperative stability and the changes in the tongue position, the hyoid bone position and the upper airway size after orthognathic surgery in patients with mandibular prognathism", Korean J Orthod, 23, pp.693~705 (1993)
- Choi JY, "A study on changes of hyoid bone position and upper airway following orthognathic surgery", Kyung Hee Dent J, 15, pp.729~742 (1993)
- Tselnik M, "Assessment of the pharyngeal airway space after mandibular setback surgery", J Oral Maxillofac Surg, 58, pp.282~285 (2000)
- Greco JM, "Long-term airway space changes after mandibular setback using bilateral sagittal split osteotomy", Int J Oral Maxillofac Surg, 19, pp.103~105 (1990)
- Enacar A, "Changes in hypopharyngeal airway space and in tongue and hyoid bone positions following the surgical correction of mandibular prognathism", Int J Adult Orthodon Orthognath Surg, 9, pp.285~290 (1994)
- Güven O, "Changes in pharyngeal airway space and hyoid bone positions after body ostectomies and sagittal split ramus osteotomies", J Craniofac Surg, 16, pp.23~30 (2005)
- Park BW, "A cephalometric study on changes in pharyngeal airway space, tongue and hyoid bone positions following the surgical correction of mandibular prognathism", J Korean Assoc Oral Maxillofac Surg, 26, pp.164~171 (2000)
- Kawakami M, "Changes in tongue and hyoid positions, and posterior airway space following mandibular setback surgery", J Craniomaxillofac Surg, 33, pp.107~110 (2005)
- Lew KK, "Changes in tongue and hyoid bone positions following anterior mandibular subapical osteotomy in patients with Class III malocclusion", Int J Adult Orthodon Orthognath Surg, 8, pp.123~128 (1993)
- Eggensperger N, "Long-term changes of hyoid bone position and pharyngeal airway size following mandibular setback by sagittal split ramus osteotomy", J Craniomaxillofac Surg, 33, pp.111~117 (2005)
- 최용하, "골격성 3급 부정교합 환자의 악교정 수술 후 설골의 위치와 기도변화에 관한 연구", Maxillofacial Plastic Reconstructive Surgery, 33(5), pp.401~406 (2011), 대한악안면성형재건외과학회
- Riley RW, "Maxillofacial surgery and obstructive sleep apnea syndrome", Otolaryngol Clin North Am, 23, pp.809~826 (1990)
- Harris RS, "The effect of extension of the head and neck upon the infrahyoid respiratory passage and the supraclavicular portion of the human trachea", Thorax, 14, pp.176~180 (1959)
- Hellsing E., "Changes in the pharyngeal airway in relation to extension of the head", Eur J Orthod, 11, pp.359~365 (1989)
- Ono T, "Effects of head and body position on two- and three-dimensional configurations of the upper airway", J Dent Res, 79, pp.1879~1884 (2000)
- Solow B, "Head posture and craniofacial morphology", Am J Phys Anthropol, 44, pp.417~435 (1976)
- Muto T, "The effect of head posture on the pharyngeal airway space (PAS)", Int J Oral Maxillofac Surg, 31, pp.579~583 (2002)
- Malkoc S, "Reproducibility of airway dimensions and tongue and hyoid positions on lateral cephalograms", Am J Orthod Dentofacial Orthop, 128, pp.513~516 (2005)
- Partinen M, "Obstructive sleep apnea and cephalometric roentgenograms. The role of anatomic upper airway abnormalities in the definition of abnormal breathing during sleep", Chest, 93, pp.1199~1205 (1988)
- Riley R, "Cephalometric analyses and flow-volume loops in obstructive sleep apnea patients", Sleep, 6, pp.303~311 (1983)
- Hochban W, "Mandibular setback for surgical correction of mandibular hyperplasia: does it provoke sleep-related breathing disorders?", Int J Oral Maxillofac Surg, 25, pp.333~338 (1996)
- Chung DH, "A study on changes of airway, tongue, and hyoid position following orthognathic surgery", Korean J Orthod, 28, pp.487~498 (1998)