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Long-term three-dimensional effects of orthognathic surgery on the pharyngeal airways: a prospective study in 128 healthy patients

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Abstract

Objective

To investigate volumetric and circumferential pharyngeal airway space (PAS) changes and stability over time as evaluated with cone beam computed tomography (CBCT) before and after orthognathic surgery 2 years postoperatively.

Materials and methods

One hundred twenty-eight patients underwent bimaxillary orthognathic surgery at the Department of Maxillofacial Surgery of University Hospitals, Leuven, Belgium, were recruited prospectively. Patients were divided into 4 groups based on the amount of mandibular advancement in 5 mm increments (< 0 mm, 0–5 mm, 5–10 mm, or > 10 mm). CBCT data was acquired preoperatively and 1–6 weeks, 6 months, 1 year, and 2 years postoperatively. Patients with a history of maxillofacial trauma or surgery, obstructive sleep apnoea syndrome, or craniofacial anomalies were excluded. Nasopharyngeal, oropharyngeal, and hypopharyngeal PAS volumes and constriction surface areas (mCSA) were measured and compared between each time point with a paired t-test.

Results

The largest significant increase in oropharyngeal volume and mCSA were observed in the 5–10 mm (+ 13.3–21.7%, + 51.3–83.0%)) and > 10 mm (+ 23.3–44.6%, + 92.3–130.0%) mandibular advancement groups. This increase only remained stable 2 years postoperatively in the > 10 mm group. In other mandibular advancement groups, short-term oropharyngeal volume and mCSA increases were noticed, which returned to baseline levels 6 months to 1 year postoperatively.

Conclusion

Bimaxillary advancement osteotomy significantly increases oropharyngeal volume and mCSA, which remains stable between 6 months to 1 year postoperatively.

Clinical relevance

Long-term stable volumetric and mCSA enlargements were found with > 10 mm mandibular advancements over a period of 2 years. Return towards baseline levels was observed in the other mandibular advancement groups.

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Funding

The study was self-funded.

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Author notes

  1. Gert-Jan Hassing and Vincent The contributed equally to this work

Authors and Affiliations

  1. Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium

    Gert-Jan Hassing, Vincent The & Maria Cadenas de Llano-Pérula

  2. OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium

    Eman Shaheen & Constantinus Politis

  3. Department of Oral and Facial Surgery, University Hospitals Leuven, Leuven, Belgium

    Eman Shaheen & Constantinus Politis

Authors
  1. Gert-Jan Hassing
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  2. Vincent The
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  3. Eman Shaheen
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  4. Constantinus Politis
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  5. Maria Cadenas de Llano-Pérula
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Corresponding author

Correspondence to Maria Cadenas de Llano-Pérula.

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Hassing, GJ., The, V., Shaheen, E. et al. Long-term three-dimensional effects of orthognathic surgery on the pharyngeal airways: a prospective study in 128 healthy patients. Clin Oral Invest 26, 3131–3139 (2022). https://doi.org/10.1007/s00784-021-04295-8

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