Correlation between oral cavity volume and upper airway changes in skeletal Class III patients undergoing bimaxillary orthognathic surgery: a pilot cone-beam computed tomography study

Gen Li, Zhenwei Chen, Yingyi Li, Guanhui Cai, Xiaolei Ruan, Ting Wang, Zhaolan Guan, Lian Sun, Wei Wang, Wen Sun, Hua Wang
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Abstract

To evaluate changes of the upper airway and oral cavity volumes in patients with skeletal Class III malocclusion undergoing bimaxillary orthognathic surgery, and to analyze the correlation between postoperative upper airway decrease and the amount of jaw movement and oral cavity volume reduction. Thirty patients (16 males and 14 females) undergoing bimaxillary surgery were included. Three-dimensional reconstruction of the upper airway and oral cavity were performed using preoperative (T0) and postoperative (T1) (6 months) cone-beam computed tomography scans. The volume, sagittal area and minimum cross-sectional area of the upper airway were diminished (P < .001). The decrease in volume and minimum cross-sectional area in the oropharyngeal region of the upper airway were weakly correlated with B-point posterior movement (P < .05). Total oral cavity volume was decreased, with maxillary oral volume increasing and mandibular oral volume decreasing (P < .001). Upper airway decrease was highly correlated with total oral volume reduction and mandibular oral volume reduction, with the most significant correlation being with total oral volume reduction (P < .001). Class III bimaxillary surgery reduced the volume, sagittal area, and minimum cross-sectional area of the upper airway as well as oral cavity volume. Upper airway changes were weakly correlated with anterior-posterior mandibular movement but significantly correlated with oral cavity volume changes. Thus, oral cavity volume reduction is a crucial factor of upper airway decrease in patients with skeletal Class III malocclusion undergoing bimaxillary orthognathic surgery.
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接受双颌正颌手术的骨骼Ⅲ级患者口腔容积与上气道变化之间的相关性:锥束计算机断层扫描试验研究
目的:评估接受双颌正畸手术的骨骼Ⅲ类错颌畸形患者上气道和口腔容积的变化,分析术后上气道缩小与下颌运动量和口腔容积缩小之间的相关性。 研究纳入了 30 名接受双颌手术的患者(男 16 名,女 14 名)。使用术前(T0)和术后(T1)(6 个月)锥束计算机断层扫描对上气道和口腔进行三维重建。 上气道的体积、矢状面积和最小横截面积均有所缩小(P < .001)。上气道口咽部容积和最小横截面积的减少与 B 点后移呈弱相关(P < .05)。口腔总容积减少,上颌口腔容积增加,下颌口腔容积减少(P < .001)。上气道缩小与口腔总容积缩小和下颌口腔容积缩小高度相关,其中与口腔总容积缩小的相关性最为显著(P < .001)。 III 类双颌手术减少了上气道的容积、矢状面积和最小横截面积以及口腔容积。上气道的变化与下颌骨前后移动的相关性较弱,但与口腔容积的变化明显相关。因此,对于接受双颌正颌手术的骨骼Ⅲ类错颌畸形患者来说,口腔容积缩小是上气道缩小的关键因素。
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