title: Change of the airway space in mandibular prognathism after bimaxillary surgery involving maxillary posterior impaction.
abstract: BACKGROUND
  The purpose of this retrospective study was to develop a two- and three-dimensional analysis of the airway using cone-beam computed tomography (CBCT) and to determine whether the airway space would be changed in mandibular prognathism after bimaxillary surgery involving maxillary posterior impaction.
  
  
  METHODS
  Patients requiring orthognathic surgery from 2012 to 2014 were recruited for this study. CBCT scans were obtained at three points: preoperatively (T0), immediate postoperatively (T1), and after 6 months postoperatively (T2). The nasopharynx, oropharynx, and hypopharynx were measured on the CBCT scan for each patient in a repeatable manner. With the midsagittal plane, linear measurements in the middle of each were obtained. For the CBCT, volumetric measurements of each and total airway were obtained.
  
  
  RESULTS
  A total of 22 consecutive patients (11 men and 11 women) were included in the present study. The total volume was significantly reduced (p< .001). However, the change of the diameter and volume of the nasopharynx was not statistically significant (p= .160,p= .137, respectively). In the oropharynx, the change of both the diameter and volume showed statistical significance between preoperatively and immediate postoperatively (p< .001,p= .001, respectively) and also preoperatively and after 6 months postoperatively (p= .001,p= .010, respectively). In the hypopharynx, the change of both the diameter and volume showed statistical significance between preoperatively and immediate postoperatively (p= .001,p< .001, respectively) and also preoperatively and after 6 months postoperatively (p= .001,p< .001, respectively).
  
  
  CONCLUSIONS
  The bimaxillary surgery involving maxillary posterior impaction can reduce the volume of airway in the patients of mandibular prognathism. Although total airway volume was reduced significantly, the changes in the volume and diameter of the nasopharynx were not statistically significant. The maxillary posterior impaction affects on the nasopharyngeal airway minimally.
authors.affiliation: Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, 7 Jukheon-gil, Gangneung, Gangwondo 210-702 South Korea.
authors.forename: Woo-Young
authors.initials: WY
authors.lastname: Lee
authors.affiliation: Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, 7 Jukheon-gil, Gangneung, Gangwondo 210-702 South Korea.
authors.forename: Young-Wook
authors.initials: YW
authors.lastname: Park
authors.affiliation: Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, 7 Jukheon-gil, Gangneung, Gangwondo 210-702 South Korea.
authors.forename: Kwang-Jun
authors.initials: KJ
authors.lastname: Kwon
authors.affiliation: Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, 7 Jukheon-gil, Gangneung, Gangwondo 210-702 South Korea.
authors.forename: Seong-Gon
authors.initials: SG
authors.lastname: Kim
keywords: Airway management; Cone-beam computed tomography; Orthognathic surgery