Upper airway changes after mandibular setback and/or advancement genioplasty in obese patients

Publication date: Available online 19 April 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Wen Du, Dongming He, Yiyao Wang, Hanghang Liu, Chuhang Liao, Wei Fei, En Luo
PurposeOrthognathic surgery, such as bilateral sagittal split ramus osteotomies (BSSRO), genioplasties, etc., could influence the pharyngeal airway space (PAS) and this proposition has been supported by former studies. The purpose of this study is to assess changes of PAS in body mass index (BMI) excessive patients likely to have narrow airways, before and after BSSRO setback and/or advancement genioplasty surgery by three-dimension CT scanning.Patients and MethodsThirty-five BMI excessive adult patients (BMI≥ 24.0) were treated from 2010 to 2016. Samples were grouped as follows: mandibular setback group (Group A) (n=11), advancement genioplasty group (Group B) (n = 12), and mandibular setback + advancement genioplasty group (Group C) (n = 12). CT-scans were taken 1 week preoperatively (T0), 1 week postoperatively (T1), and at least 1 year postoperatively (T2). The area of PNS-posterior plane (PPA), soft-palate plane (SPA), the most posterior point of tongue base plane (PTA), and the root of epiglottis plane (EA); and the volume of palatopharyngeal part (VP), oropharyngeal part (VO), glossopharyngeal part (VG), and laryngeal part (VL) were measured and compared intra-group with analysis of variance. P value was set at .05.ResultsIn Group A, all results showed statistically significant differences (P<0.05) except VO, VG, VL, SPA, PTA, and EA between T0 and T2. In Group B, VO, VG, VL, SPA, PTA, and EA showed statistically significant increases (P<0.05) between T0 and T2. The hyoid in T2 had a significant advancement compared to T0 (P<0.05). In Group C, there were statistically significant decreases (P<0.05) for VG, VL, PTA, and EA between T0 and T1.ConclusionAmong BMI excessive individuals, the mandibular BSSRO setback may postoperatively decrease the PAS, while an advancement genioplasty may enlarge the PAS after surgery. Therefore, receiving advancement genioplasty concurrently during a BSSRO setback mandibular surgery may help in reducing the negative effects of a PAS decrease.



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