Volumetric analysis of pharyngeal airway dimensions and hyoid bone position following orthognathic surgery in skeletal class III patients: a cross sectional cephalometric study

Amrit Thapa, I. D. Roy, B. Jayan, Saugat Ray, Andrews Navin Kumar, Amit Antil
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Abstract

Background: Objective of the study was to determine linear and volumetric changes in pharyngeal airway dimensions in class III patients treated by different modalities of orthognathic surgery and to compare the results of different orthognathic surgical modalities, and determine the change at the position of the hyoid bone. Methods: Pre and post-treatment lateral cephalogram of 53 class III adult patients who were treated by different modalities of orthognathic surgery studied to assess the changes in pharyngeal airway dimensions and hyoid bone position after orthognathic surgery. 28 patients were treated with mandibular set back, and 25 patients were treated with Bijaw surgery. Lateral cephalogram records were taken before treatment (T1), after surgery (T2), the end of the fixed treatment (T3) and 1 year after debonding (T4). Results: Interception of both surgical modalities has significant impact on various skeletal and pharyngeal parameters i.e., BMeH (0.00), PNS (0.009), MPS (0.13), GOP (0.001), IPS (0.007), SAS (0.006), and MAS (0.00). OJ (overjet) and OB (overbite) was significant especially after time interval of one year. In Bijaw groups, PPST4 parameter was significantly increased (0.0000), SPST4 (0.000), GOP (0.000), EPS (0.000) and IPS parameter was significantly decreased (0.045). Significant difference was observed in T4 time interval in superior pharyngeal airway space, posterior airway space and middle airway space with (p<0.05). Conclusions: Pharyngeal airway is significantly altered following orthognathic surgery in class III patients and it depends on the type of surgical modality employed were Bijaw surgery has significant impact on oropharyngeal and hypopharyngeal airway space.
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III类骨骼患者正颌手术后咽气道尺寸和舌骨位置的体积分析:一项横断面头颅测量研究
背景:本研究的目的是确定III类患者接受不同方式的正颌手术后咽部气道尺寸的线性和体积变化,并比较不同正颌手术方式的结果,确定舌骨位置的变化。方法:对53例接受不同方式正颌手术治疗的成人III类患者进行治疗前后侧位头颅造影,评估正颌手术后咽气道尺寸和舌骨位置的变化。28例患者行下颌骨后移手术,25例患者行双颌手术。分别于治疗前(T1)、手术后(T2)、固定治疗结束(T3)及脱粘后1年(T4)进行侧位脑电图记录。结果:两种手术方式的阻断对BMeH(0.00)、PNS(0.009)、MPS(0.13)、GOP(0.001)、IPS(0.007)、SAS(0.006)和MAS(0.00)等骨骼和咽参数均有显著影响。OJ (overjet)和OB (overbite)在间隔1年后表现尤为显著。Bijaw组PPST4参数显著升高(0.0000),SPST4参数显著升高(0.000),GOP参数显著降低(0.000),EPS参数显著降低(0.000),IPS参数显著降低(0.045)。在咽上气道间隙、后气道间隙和中气道间隙T4时间间隔上,均有统计学差异(p < 0.05)。结论:III类患者正颌手术后咽部气道明显改变,双颌手术对口咽和下咽气道间隙的影响取决于手术方式的类型。
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