Skip to main content

Advertisement

Log in

Effect of Mandibular Advancement Surgery on Tongue Length and Height and Its Correlation with Upper Airway Dimensions

  • Original Article
  • Published:
Journal of Maxillofacial and Oral Surgery Aims and scope Submit manuscript

Abstract

Introduction

The spatial position and dimensions of oral and pharyngeal soft tissues change post-mandibular advancement (MA) surgery which involves changes in position of soft palate, tongue and associated musculature. There is no study which simultaneously evaluates changes in tongue length and height post-MA surgery and correlates these changes with changes in upper airway dimensions and the amount of MA.

Materials and Methods

Treatment records of 18 patients that underwent MA with bilateral sagittal split ramus osteotomy were evaluated at T1 (01 week before surgery) and T2 (06 months post-surgery). Linear airway and tongue measurements were done on lateral cephalogram. Mean volume and mean pharyngeal area values were recorded from the acoustic pharyngometry (AP) records of patients.

Results

A statistically significant increase in tongue length (P value < 0.001) and nonsignificant change in tongue height were observed at T2 (P value > 0.05). A statistically significant increase in airway parameters recorded on both lateral cephalogram and AP was observed at T2 (P value < 0.001). Correlation analysis did not show a statistically significant correlation of change in tongue length and tongue height at T2 with the amount of MA, change in airway parameters on lateral cephalogram and AP (P value > 0.05).

Conclusions

Mandibular advancement surgery is a viable option for improvement in pharyngeal airway in skeletal Class II patients with retrognathic mandible. Changes in tongue length observed in our study may correspond to the stretch of protruders of tongue, especially genioglossus, and may point toward possible relapse on a long-term follow-up.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Eggensperger N, Smolka W, Iizuka T (2005) Long term changes of hyoid bone position and pharyngeal airway size following mandibular setback by sagittal split ramus osteotomy. J Cranio Maxillo Fac Surg 33:111–117

    Article  Google Scholar 

  2. Sahoo NK, Roy ID, Kulkarni V (2018) Mandibular setback and its effects on speech. Oral Maxillofac Surg Cases. https://doi.org/10.1016/j.omsc.2018.10.001

    Article  Google Scholar 

  3. Zaghi S, Holty CEJ, Certal V et al (2016) Maxillomandibular advancement for treatment of obstructive sleep apnea: a meta-analysis. JAMA Otolaryngol Head Neck Surg 142(1):58–66

    Article  Google Scholar 

  4. Marsan G, Oztas E, Cura N, Kuvat SV, Emekli U (2010) Changes in head posture and hyoid bone position in Turkish Class III patients after mandibular setback surgery. J Cranio Maxillo Fac Surg 38:113–121

    Article  Google Scholar 

  5. Chen F, Terada K, Hua Y, Saito I (2007) Effect of bimaxillary surgery and mandibular setback surgery on pharyngeal airway measurements in patients with class III skeletal deformities. Am J Dentofac Orthop 131:372–377

    Article  Google Scholar 

  6. Guven O, Saracoglu U (2005) Changes in pharyngeal airway space and hyoid bone positions after body ostectomies and sagittal split ramus osteotomies. J Craniofac Surg 16:23–30

    Article  Google Scholar 

  7. Hasebe D, Kobayashi T, Hasegawa M et al (2011) Changes in oropharyngeal airway and respiratory function during sleep after orthognathic surgery in patients with mandibular prognathism. Int J Oral Maxillofac Surg 40:584–592

    Article  CAS  Google Scholar 

  8. Yoshida K, Rivera GA, Matsuo N et al (2000) Long-term prognosis of BSSO mandibular relapse and its relation to different facial types. Angle Orthod 70:220–226

    CAS  PubMed  Google Scholar 

  9. Tangugsorn V, Skatvedt O, Krogstad O, Lyberg T (1995) Obstructive sleep apnea: a cephalometric study. Part I. Cervico-craniofacial skeletal morphology. Eur J Orthod 17:45–56

    Article  CAS  Google Scholar 

  10. Tsuchiya M, Lowe AA, Pae EK, Fleetham JA (1992) Obstructive sleep apnea subtypes by cluster analysis. Am J Orthod Dentofac Orthop 101:533–542

    Article  CAS  Google Scholar 

  11. Kaur S, Rai S, Sinha A, Ranjan V, Mishra D, Panjwani S (2015) A lateral cephalogram study for evaluation of pharyngeal airway space and its relation to neck circumference and body mass index to determine predictors of obstructive sleep apnea. J Indian Acad Oral Med Radiol 27:2–8

    Article  Google Scholar 

  12. Turvey TA, Hall DJ (1984) Alteration in nasal airway resistance following superior repositioning of the maxilla. Am J Orthod Dentofac Orthop 45:109–114

    Article  Google Scholar 

  13. Zhou L, Zhao Z, Lu D (2000) The analysis of the changes of tongue shape and position, hyoid position in Class II, division 1 malocclusion treated with functional appliances (FR-I). Hua Xi Kou Qiang Yi Xue Za Zhi 18(2):123–125

    CAS  PubMed  Google Scholar 

  14. Tseng Y, Wu J, Chen C, Hsu K (2017) Correlation between change of tongue area and skeletal stability after correction of mandibular prognathism. Kaohsiung J Med Sci. https://doi.org/10.1016/j.kjms.2017.03.008

    Article  PubMed  Google Scholar 

  15. Yamaoka M, Furusawa K, Uematsu T, Okafuji N, Kayamoto D, Kurihara S (2003) Relationship of the hyoid bone and posterior surface of the tongue in prognathism and micrognathia. J Oral Rehabil 30:914–920

    Article  CAS  Google Scholar 

  16. Takahashi S, Kuribayashi G, Ono T, Ishiwata Y, Kuroda T (2005) Modulation of masticatory muscle activity by tongue position. Angle Orthod 75:35–39

    PubMed  Google Scholar 

  17. Malkoc S, Usumez S, Nur M, Donaghy CE (2005) Reproducibility of airway dimensions and tongue and hyoid positions on lateral cephalograms. Am J Orthod Dentofac Orthop 128:513–516

    Article  Google Scholar 

  18. Aboudara C, Nielsen I, Huang JC, Maki K, Miller AJ, Hatcher D (2009) Comparison of airway space with conventional lateral headfilms and 3 dimensional reconstruction from cone beam computed tomography. Am J Orthod Dentofac Orthop 135:468–479

    Article  Google Scholar 

  19. Riley RW, Powell NB, Guilleminault C (1990) Maxillary, mandibular, and hyoid advancement for treatment of obstructive sleep apnea: a review of 40 patients. J Oral Maxillofac Surg 48:20–26

    Article  CAS  Google Scholar 

  20. Miles PG, O’Reilly M, Close J (1995) The reliability of upper airway landmark identification. Aust Orthod J 14:3–6

    CAS  PubMed  Google Scholar 

  21. Agarwal SS, Jayan B, Kumar S (2015) Therapeutic efficacy of a hybrid mandibular advancement device in the management of obstructive sleep apnea assessed with acoustic reflection technique. Indian J Dent Res 26:86–89

    Article  CAS  Google Scholar 

  22. Achilleos S, Krogstad O, Lyberg T (2000) Surgical mandibular advancement and changes in uvuloglossopharyngeal morphology and head posture: a short- and long-term cephalometric study in males. Eur J Orthod 22:367–381

    Article  CAS  Google Scholar 

  23. Turnbull NR, Battagel JM (2000) The effects of orthognathic surgery on pharyngeal airway dimensions and quality of sleep. J Orthod 27:235–247

    Article  CAS  Google Scholar 

  24. Sriram SG, Andrade NN (2014) Cephalometric evaluation of the pharyngeal airway space after orthognathic surgery and distraction osteogenesis of the jaw bones. Indian J Plast Surg 47:346–353

    Article  Google Scholar 

  25. Lowth A, Juge L, Knapman F et al (2018) Dynamic MRI tongue deformation patterns during mandibular advancement and associations with craniofacial anatomy in OSA. J Sleep Res. https://doi.org/10.1111/jsr.169_12766

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to N. K. Sahoo.

Ethics declarations

Conflict of interest

The authors declare that they have no competing interests.

Ethics Statement

The study design was approved by the institutional ethical committee.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sahoo, N.K., Agarwal, S.S., Datana, S. et al. Effect of Mandibular Advancement Surgery on Tongue Length and Height and Its Correlation with Upper Airway Dimensions. J. Maxillofac. Oral Surg. 19, 624–629 (2020). https://doi.org/10.1007/s12663-020-01375-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12663-020-01375-2

Keywords

Navigation