Preliminary Evaluation of Upper Airway Alteration after Bimaxillary Orthognathic Surgery in Patients with Skeletal Class Ⅱ Malocclusion via Three Dimensional Reconstruction Techniques

doi:10.13701/j.cnki.kqyxyj.2021.11.018

Abstract

Abstract: Objective: To evaluate the upper airway dimension changes in skeletal Class Ⅱ patients treated with bimaxillary orthognathic surgery through spiral computed tomography. Methods: Twelve patients (4 males and 8 females) with skeletal Class Ⅱ malocclusion underwent LeFort I osteotomy and bilateral sagittal split mandibular advancement was selected. Spiral CT data were collected 1 week before operation (T0), 3 days after operation (T1), and 6-12 months after operation (T2). The cross-sectional diameter, length and volumes of the airway in T0, T1 and T2 were measured. The data in T0, T1 and T2 were compared. Results: The vertical diameter of Anp plane, the airway length of the nasopharynx, the glossopharynx and the total upper airway decreased significantly 3 days and 6-12 months [(3.42±3.68) mm, (3.42±3.68) mm, (2.83±3.89) mm, and (6.02±8.23) mm] after surgery. The cross-section area of Anp plane, the sagittal diameter and cross-section area of Lnp plane, the glossopharynx airway volume, the transverse diameter of Lvp plane, the velopharynx airway volume decreased significantly 3 days after surgery, and returned to preoperative level 6-12 months after surgery. The sagittal diameter and cross-section area of Lvp plane and Lgp plane, the glossopharynx airway volume increased significantly 6-12 months [(3.90±3.83) mm, (25.16±68.21) mm², (3.26±3.74) mm, (34.55±89.41) mm², and (1091.63±1382.39) mm³] after surgery. The change degree of the glossopharynx airway volume 6-12 months after surgery was positively correlated with the sagittal movement distance of point B. Conclusion: The glossopharynx airway volume increased in skeletal Class Ⅱ patients after bimaxillary orthognathic surgery, the increase degree was positively correlated with the sagittal movement distance of the mandible. The velopharynx airway decreased significantly 3 days after surgery, and returned to preoperative level 6-12 months after surgery. There was no significant difference in the nasopharynx, the hypopharynx, and the total upper airway volume.

Key words: skeletal Class Ⅱ malocclusion, bimaxillary orthognathic surgery, upper airway, spiral computed tomography

ZHANG Kun, ZOU Weina, PU Yumei, HU Xiaobei, WANG Yuxin. Preliminary Evaluation of Upper Airway Alteration after Bimaxillary Orthognathic Surgery in Patients with Skeletal Class Ⅱ Malocclusion via Three Dimensional Reconstruction Techniques[J]. Journal of Oral Science Research, 2021, 37(11): 1048-1053.

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