Airway changes and prevalence of obstructive sleep apnoea after bimaxillary orthognathic surgery with large mandibular setback |
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| Institution: | 1. Orthognathic Surgery Center, Seoul National University Dental Hospital, Republic of Korea;2. Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Republic of Korea;3. Department of Oral and Maxillofacial Surgery, Soonchunhyang University Bucheon Hospital, Republic of Korea;4. Dental Research Institute, Seoul National University, Republic of Korea;1. University of Heidelberg, Department of Oral and Maxillofacial Surgery, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany;2. Oral Surgery Practice, Hindenburgstraße 1, D-67433 Neustadt an der Weinstraße, Germany;3. Practice Clinic of Oral and Maxillofacial Surgery, Darmstädter Str. 7, D-64625 Bensheim, Germany;1. Department of Stomatology Bauru Dental School, University of São Paulo, Alameda Dr. Otávio Pinheiro Brisola, 9-75 - Vila Nova Cidade Universitaria, Bauru, SP, 17012-901, Brazil;2. University of Ribeirao Preto – UNAERP, Av. Costábile Romano, 2201, Ribeirão Preto, SP, CEP: 14096-900, Brazil;3. Universidade Federal do Ceará, Departamento de Cirurgia e Traumatologia Bucomaxilofacial, Fortaleza, Brazil;1. Dental Officer Specialist and Clinical Researcher, Cleft and Craniofacial Centre and Dental Service, KK Women''s and Children''s Hospital, Singapore;2. Head and Consultant, Cleft and Craniofacial Centre and Dental Service, KK Women''s and Children''s Hospital, Singapore;3. Head and Senior Consultant, Cleft and Craniofacial Centre, Paediatric Plastic Surgery, Cleft and Craniomaxillofacial Surgery, KK Women''s and Children''s Hospital, Singapore;4. Visiting Senior Consultant, Cleft and Craniofacial Centre, Paediatric Plastic Surgery, Cleft and Craniomaxillofacial Surgery, KK Women''s and Children''s Hospital, Singapore;6. Visiting Consultant, Cleft and Craniofacial Centre and Dental Service, KK Women''s and Children''s Hospital, Singapore;5. Visiting Consultant, Cleft and Craniofacial Centre and Dental Service, KK Women''s and Children''s Hospital, Singapore;1. Associate professor, Department of Orthodontics, Dental Sciences Center, Gulhane Military Medical Academy, Etlik, Ankara, Turkey;2. Associate professor, Medical Design and Manufacturing Center, Gulhane Military Medical Academy, Etlik, Ankara, Turkey;3. Professor and chairman of Dental Sciences Center, Department of Orthodontics, Gulhane Military Medical Academy, Etlik, Ankara, Turkey;4. Associate professor, Department of Radiology, Gulhane Military Medical Academy, Etlik, Ankara, Turkey;1. Resident, Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital, Yangsan, South Korea;2. Professor, Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital, Yangsan, South Korea;3. Clinical Associate Professor, Department of Orthodontics, Biomedical research institute, Pusan National University Hospital, Busan, South Korea;4. Physician, Private Practice, Barun Dental Hospital, Busan, South Korea;6. Associate Professor, Department of Orthodontics, Center for Advanced Dental Education, Saint Louis University, Saint Louis, MO;5. Associate Professor, Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital, Yangsan, South Korea; and Institute of Translational Dental Science, Pusan National University, Busan, South Korea |
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| Abstract: | This study used three-dimensional computed tomography and polysomnography to evaluate the effect of a large mandibular setback on the postoperative pharyngeal airway space and obstructive sleep apnoea (OSA). Twelve patients who underwent bimaxillary surgery for a mandibular setback movement of >9 mm were included in this study. Changes in the pharyngeal airway space and polysomnography parameters based on the surgical movements were analyzed. The median mandibular setback movement was 11.08 mm. The total pharyngeal, oropharyngeal, and hypopharyngeal volumes, and the retroglossal cross-sectional area were significantly decreased postoperatively (P = 0.006; P = 0.005; P = 0.012; P = 0.005, respectively). The apnoea–hypopnoea index (AHI) increased significantly after surgery (P = 0.021). There were significant positive correlations between the preoperative inferiorly located hyoid bone and both AHI and respiratory disturbance index (RDI) postoperative (P = 0.008 and P = 0.027) and between the postoperative inferiorly dislocated retropalatal level and both AHI and RDI postoperative (P = 0.002 and P = 0.014). Four patients (33.3%) developed new onset OSA postoperatively. Large mandibular setback movements significantly reduced the pharyngeal airway space in the setting of bimaxillary surgery (P = 0.006). |
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| Keywords: | large mandibular setback pharyngeal airway space computed tomography polysomnography obstructive sleep apnoea |
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