title: Changes in Upper Airway Volume Following Orthognathic Surgery.
abstract: Reduced volume of the internal skeletal dimensions of the face is 1 of the main causes of obstructive sleep apnea, and attention to patients' airways is necessary when planning orthognathic treatment. This study aims to describe changes in upper airway volume following virtually planned orthognathic surgery.A retrospective pilot study was designed with 30 randomly selected patients (10 men and 20 women, aged 23.1 ± 6.8 years, molar-relations: 15 neutral, 8 distal, and 7 mesial). Cone-beam computed tomography scans were performed before surgery and 1 week following surgery. The authors did total upper airway volume measurements and obtained 1-mm slices at vertical levels in the velo-, oro-, and hypopharynx and at the smallest visible cross-section.Measurements before and after surgery were compared using Student t test.After orthognathic surgery, the minimum cross-sectional area at the vertical level increased from 83 mm ± 33 before surgery to 102 mm ± 36 after surgery (P = 0.019). In patients with neutral and distal occlusions, the minimum cross-sectional slice volume increased in 87% but in only 57% with mesial occlusion.The present findings suggest that orthognathic surgery increases upper airway volume parameters, but a few patients have continued impairment of the airways following orthognathic surgery. Further studies are needed to confirm an individual surgical planning approach that potentially could bring the minimum cross sectional area out of the risk zone.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Odense University Hospital, Odense, Denmark.
authors.forename: Lillian
authors.initials: L
authors.lastname: Marcussen
authors.forename: Kasper
authors.initials: K
authors.lastname: Stokbro
authors.forename: Esben
authors.initials: E
authors.lastname: Aagaard
authors.forename: Peter
authors.initials: P
authors.lastname: Torkov
authors.forename: Torben
authors.initials: T
authors.lastname: Thygesen
mesh_terms: D000293:Adolescent; D000328:Adult; D000402:Airway Obstruction / Q000503:physiopathology* / Q000601:surgery*; D002508:Cephalometry / Q000379:methods; D003198:Computer Simulation; D054893:Cone-Beam Computed Tomography; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008875:Middle Aged; D056948:Orthognathic Surgical Procedures / Q000009:adverse effects* / Q000379:methods*; D010865:Pilot Projects; D011183:Postoperative Complications / Q000503:physiopathology*; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology*; D025321:Surgery, Computer-Assisted; D014584:User-Computer Interface; D055815:Young Adult