title: Effects of orthognathic surgery on pharyngeal airway and respiratory function during sleep in patients with mandibular prognathism.
abstract: The aim of this study was to determine changes in overnight respiratory function and craniofacial and pharyngeal airway morphology following orthognathic surgery. The subjects were 40 patients in whom mandibular prognathism was corrected by orthognathic surgery: a one-jaw operation in 22 patients and a two-jaw operation in 18 patients. Morphological changes were studied using cone beam computed tomography immediately before surgery and at more than 6 months after surgery, and the apnoea-hypopnoea index (AHI) was measured with a portable polysomnography system. Pharyngeal airway volume was decreased significantly after surgery, especially in the one-jaw operation group. AHI was not changed significantly after surgery in either group, although AHI in one patient in the one-jaw operation group was increased to 19 events/h. There was no significant change in pharyngeal airway morphology in that patient, but he was obesity class 1 and was 54 years old. In conclusion, some patients who are obese, have a large amount of mandibular setback, and/or are of relatively advanced age may develop sleep-disordered breathing after mandibular setback; a two-jaw operation should therefore be considered in skeletal class III patients who have such risks because it decreases the amount of pharyngeal airway space reduction caused by mandibular setback surgery.
authors.affiliation: Division of Reconstructive Surgery for Oral and Maxillofacial Region, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. Electronic address: uesugi@dent.niigata-u.ac.jp.
authors.forename: T
authors.initials: T
authors.lastname: Uesugi
authors.affiliation: Division of Reconstructive Surgery for Oral and Maxillofacial Region, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Division of Reconstructive Surgery for Oral and Maxillofacial Region, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: D
authors.initials: D
authors.lastname: Hasebe
authors.affiliation: Division of Oral and Maxillofacial Radiology, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Tanaka
authors.affiliation: Division of Oral and Maxillofacial Radiology, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Ike
authors.affiliation: Division of Reconstructive Surgery for Oral and Maxillofacial Region, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: C
authors.initials: C
authors.lastname: Saito
mesh_terms: D000293:Adolescent; D000328:Adult; D054893:Cone-Beam Computed Tomography; D005260:Female; D006801:Humans; D008297:Male; D008313:Malocclusion, Angle Class III / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D009305:Nasopharynx / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D017286:Polysomnography / Q000295:instrumentation; D011183:Postoperative Complications / Q000503:physiopathology*; D011378:Prognathism / Q000601:surgery*; D011446:Prospective Studies; D012119:Respiration; D012893:Sleep Wake Disorders / Q000503:physiopathology*; D016896:Treatment Outcome
keywords: cone beam computed tomography; jaw deformity; mandibular setback surgery; pharyngeal airway; respiratory function during sleep