Influence of bimaxillary surgery on pharyngeal airway in Class III deformities and effect on sleep apnoea: A STOP-BANG questionnaire and cone beam computed tomography study

Publication date: Available online 1 June 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Narayan H. Gandedkar, Chai Kiat Chng, Yong Chen Por, Vincent Kok Leng Yeow, Andrew Ow Tjin Chiew, Tian Ee Seah
PurposeTo evaluate pharyngeal airway space (PAS) (nasopharyngeal, oropharyngeal, total airway) volume, and correlation of obstructive sleep apnea and hypopnea syndrome (OSAHS) screening questionnaire (STOP-BANG) in various mandibular set-back surgery during bimaxillary surgery, and compare with an age- and sex-matched skeletal Class I controls.Patients and MethodsThe retrospective cohort study composed of skeletal Class III patients with bimaxillary jaw surgery were assessed with STOP-BANG score, cephalometric assessment, and cone-beam computed tomography (PAS). The predictor variable was bimaxillary jaw surgery and included 4 mm set-back, 6 mm set-back, and 8 mm set-back. The primary outcome variables were the PAS volume, body mass index (BMI), and STOP-BANG score evaluated at 1-week before-surgery and after comprehensive orthodontic treatment (11.25±1.95 months). Other variables were grouped into the following categories: demographic, cephalometric parameters. The statistical differences between intragroup and intergroup were assessed by paired 't' and independent 't' tests (p<0.05) respectively.ResultsThe study sample composed of 48 patients (18-25 years) were grouped as follows: Group I (4 mm set-back) (n=16), Group II (6 mm set-back) (n=16), and Group III (8 mm set-back) (n=16) mandibular set-back surgery, with all test groups receiving 4 mm maxillary advancement. The study group was compared with skeletal Class I normal control (NC) (n=16). Group I and II's post-orthodontic treatment PAS (total volume) showed significant reduction in-comparison to pre-surgery PAS (p<0.001), but the reduction was not lesser than control group's PAS (p>0.05).In contrast, Group III's post-orthodontic treatment PAS total volume (23574±1394 mm³) was lesser than normal control PAS (23884±1543 mm³).ConclusionThe Class III subjects, post-surgically, demonstrated a decrease in oropharynx volume; however the STOP-BANG questionnaire showed no change in the risk factors scores of OSA at four to eight millimeter set-back surgery of mandible in bimaxillary jaw surgery.



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