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Evaluation of Three-Dimensional Changes in Pharyngeal Airway Following Isolated Lefort One Osteotomy for the Correction of Vertical Maxillary Excess: A Prospective Study

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Abstract

Background

Orthognathic surgery involves movement of jaws in all three planes, and this being a part of airway complex, displacement of jaws can influence the dimension of airway at all levels. Lefort one osteotomy surgery with superior repositioning is a common procedure done for patients with vertical maxillary excess

Purpose

The purpose of this study was to evaluate the three-dimensional volumetric changes in airway after lefort one impaction surgery using three-dimensional cone beam computed tomography (3D-CBCT) in patients with vertical maxillary excess (VME).

Methods

A prospective analysis of 15 patients who underwent isolated lefort one impaction surgery was done with pre-operative (T0) and 3-months (T1) post-operative 3D-CBCT scans. Airway was divided into three segments, nasopharyngeal, velopharyngeal and oropharyngeal. Volumetric analysis of all these segments was done before and after surgery. Paired ‘t test’ was used to assess the mean difference in airway volume and area between T0 and T1. One-way ANOVA was used to check the mean percentage difference in airway volume and area among the three segments.

Results

The mean percentage of nasopharyngeal volume difference was − 0.6299 ± 0.9146%, velopharyngeal volume difference was − 0.5205 ± 1.107%, oropharyngeal volume difference was − 1.492 ± 2.745%. Though volume and area of pharyngeal airway were decreased after maxillary impaction surgery in all three segments of airway studied, they were not statistically significant.

Conclusion

Among the three segments of airway studied, oropharyngeal airway volume has shown the highest post-surgical reduction though statistically insignificant. ESS scores were within normal limits. Hence, we are of the opinion that there is lack of evidence to conclude that the patients undergoing lefort one superior repositioning for the treatment of VME might develop significant narrowing of PAS that may predispose the patient to breathing disorders.

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Acknowledgements

We thank M/s Essential Dental Products, New Delhi, for helping us with the Dolphin software.

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Author notes

  1. S. Vijayakumar Jain

    Present address: Department of Oral and Maxillofacial Surgery, Sri Hasanamba Dental College and Hospital, Hassan, Karnataka, 573202, India

Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Saveetha University, 162, Poonamallee High Road, Velappanchavadi, Chennai, Tamil Nadu, 600077, India

    M. R. Muthusekhar, M. F. Baig, P. Senthilnathan, S. Loganathan, P. U. Abdul Wahab & M. Madhulakshmi

  2. New Delhi, 110060, India

    Yogaen Vohra

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  1. S. Vijayakumar Jain
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Correspondence to S. Vijayakumar Jain.

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Vijayakumar Jain, S., Muthusekhar, M.R., Baig, M.F. et al. Evaluation of Three-Dimensional Changes in Pharyngeal Airway Following Isolated Lefort One Osteotomy for the Correction of Vertical Maxillary Excess: A Prospective Study. J. Maxillofac. Oral Surg. 18, 139–146 (2019). https://doi.org/10.1007/s12663-018-1113-4

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  • DOI: https://doi.org/10.1007/s12663-018-1113-4

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