Pharyngeal Airway Morphology in Skeletal Class III With Mandibular Asymmetry is Improved After Bimaxillary Orthognathic Surgery

Hai-Van Giap; Jeong Won Shin; Hwa Sung Chae; Young Ho Kim; Jun-Young Paeng; Hae Won Choi

doi:10.1016/j.joms.2021.01.001

Pharyngeal Airway Morphology in Skeletal Class III With Mandibular Asymmetry is Improved After Bimaxillary Orthognathic Surgery

J Oral Maxillofac Surg. 2021 May;79(5):1107-1121. doi: 10.1016/j.joms.2021.01.001. Epub 2021 Jan 9.

Authors

Hai-Van Giap¹, Jeong Won Shin², Hwa Sung Chae³, Young Ho Kim⁴, Jun-Young Paeng⁵, Hae Won Choi⁶

Affiliations

¹ Graduate student, Department of Orthodontics, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Korea.
² Clinical Professor, Department of Orthodontics, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Korea.
³ Adjunctive Professor, Department of Orthodontics, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Korea.
⁴ Professor, Department of Orthodontics, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Korea.
⁵ Clinical Professor, Department of Oral and maxillofacial surgery, The Institute of Oral Health Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
⁶ Clinical Associate Professor, Department of Orthodontics, The Institute of Oral Health Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Electronic address: orthochoi7@gmail.com.

PMID: 33549539
DOI: 10.1016/j.joms.2021.01.001

Abstract

Purpose: The relationship between pharyngeal airway morphology and jawbone movements in skeletal Class III patients with mandibular asymmetry after orthognathic surgery remains unclear. This study was to measure the changes in pharyngeal airway morphology in skeletal Class III patients with mandibular asymmetry after bimaxillary surgery and evaluate associations between changes in pharyngeal airway morphology and skeletal movements.

Methods: In this retrospective cohort study, skeletal Class III patients who underwent bimaxillary surgery were enrolled. The predictor variable was facial symmetry status divided into 2 groups, asymmetric (Group A) and symmetric (Group B). The primary outcome variables were changes in airway parameters, including cross-sectional linear distances, cross-sectional area (CSA), minimum CSA (Min-CSA), and volume; and airway asymmetry index between the preoperative and 6-month postoperative imaging studies. Correlation analysis was performed between upper airway and skeletal changes.

Results: Twenty-five patients were included in this study, with 15 patients in Group A (mean age: 23.00 years; BMI: 22.83) and 10 patients in Group B (mean age: 22.30 years; BMI: 22.48). Group A showed a higher asymmetry index than Group B at T0; however, no significant differences compared to Group B at T1. The airway volume was significantly decreased in the oropharynx in Group A at T1, whereas it showed no significant differences in Group B (P < .05). Lateral movement of B point and Menton showed positive correlations with changes in Min-CSA in the oropharynx and negative correlations with changes in airway asymmetry index (P < .05).

Conclusions: Pharyngeal airway exhibited an asymmetrical and constricted morphology in Group A before surgery. The airway morphology in Group A showed a tendency to adopt a symmetrical and less constricted shape after surgery. The airway space was reduced in the oropharynx in Group A after surgery. Surgical correction of mandibular asymmetry correlated with the improvement of pharyngeal airway morphology.

MeSH terms

Adult
Cephalometry
Cone-Beam Computed Tomography
Humans
Malocclusion, Angle Class III* / diagnostic imaging
Malocclusion, Angle Class III* / surgery
Orthognathic Surgery*
Orthognathic Surgical Procedures*
Pharynx / diagnostic imaging
Retrospective Studies
Young Adult