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Cephalometric Evaluation of Changes in Pharyngeal Airway Space in Patients Undergoing Simultaneous Orthognathic Surgery: Mandibular Setback and Maxillary Advancement Before and After Surgery
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J Mohammadi    , A Gosili , A Asalforoush Rezaiye , P Mohammadi * |
| 3.School of Dentistry, Zanjan University of Medical Sciences, Zanjan, I.R.Iran. & 4.Department of Periodontology, School of Dentistry, Gilan University of Medical Sciences, Rasht, I.R.Iran. , parisa.mohammadii1376@gmail.com |
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Abstract: (10 Views) |
Background and Objective: Upper airway and their related muscles are directly or indirectly connected to the maxilla or mandible. The displacement and jaw position in orthognathic surgeries affect their position. As a result, it seems necessary to evaluate airway changes after surgical treatments. The aim of this study was to determine the effects of orthognathic surgery on the dimensions of the upper airway in operated patients from cephalograms prepared from them.
Methods: In this study, cephalometric images of 24 patients with Class III malocclusion who underwent simultaneous mandibular setback and maxillary advancement surgery were evaluated. The patients’ airways were assessed using the Arnett-Gunson analysis at three levels: nasopharynx, oropharynx, and hypopharynx, to determine potential changes. Additionally, the mean and standard deviation of various distances—including Aa–Ap, S1a–S1p, and Ba–Bp—were analyzed before and after surgery. Finally, the A+B outcome was measured on the patients' cephalostats, and the correlation of A+B changes with nasopharynx, oropharynx, and hypopharynx dimensions was assessed.
Findings: The mean airway dimensions in the nasopharynx, oropharynx, and hypopharynx before surgery were 12.97±3.93 mm, 9.16±2.85 mm, and 14.45±4.81 mm, respectively. After surgery, these values were 15.83±4.09 mm, 10.66±2.46 mm, and 10.08±2.76 mm, respectively. Significant differences were observed in the changes in airway dimensions at the nasopharynx, oropharynx, and hypopharynx levels before and after surgery (p<0.001, p<0.045, and p<0.001, respectively). The results indicated an increase in the airway space at the nasopharynx and oropharynx levels and a decrease at the hypopharynx level following bimaxillary surgery. Correlation analysis revealed a significant positive correlation between the A+B outcome and the Ba-Bp variable at the 5% significance level, and a significant negative correlation between the A+B outcome and the Aa-Ap and S1a–S1p variables.
Conclusion: Simultaneous mandibular setback and maxillary advancement orthognathic surgeries result in an increase in the airway space in the nasopharynx and oropharynx, while the airway space in the hypopharynx decreases. |
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| Keywords: Cephalometry, Orthognathic Surgery, Mandibular Setback, Maxillary Advancement, Airway Obstruction. |
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Type of Study: Dicscriptive |
Subject:
Oral and Maxillofacial Surgery
Received: 2025/03/9 | Accepted: 2025/08/5
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