Pharyngeal Airway Space and Hyoid Bone Positioning After Different Orthognathic Surgeries in Skeletal Class II Patients
Pharyngeal Airway Space and Hyoid Bone Positioning After Different Orthognathic Surgeries in Skeletal Class II Patients
复制标题
骨性 II 类患者不同正颌手术后的咽部气道间隙和舌骨定位
DOI：
10.1016/j.joms.2017.02.021
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发表时间：
2017-07-01
影响因子：
1.9
通讯作者：
Wang, Jun
中科院分区：
文献类型：
--
作者：
Jiang, Chunmiao;Yi, Yating;Wang, Jun
目的：为获得良好的面型，严重骨性Ⅱ类错（牙合）患者需要正颌手术，这可能改变其气道空间，进而影响其睡眠质量。本研究旨在：1）确定不同正颌手术对骨性Ⅱ类错（牙合）患者咽气道空间和舌骨位置的影响；2）评估正颌手术后咽气道空间和舌骨位置变化的稳定性。
材料和方法：本回顾性队列研究纳入接受下颌前徙（MA）或下颌前徙伴上颌后退（MAMS）的严重骨性Ⅱ类错（牙合）患者。将咽气道空间和舌骨位置的变化作为主要观察变量。使用Dolphin Imaging Software 11.0在术前（T1）、术后1个月（T2）和术后2年（T3）进行测量。计算T2与T1以及T3与T1之间测量值的差异，并将其导入SPSS 22.0进行数据分析。
结果：共纳入50例患者（MA组25例，MAMS组25例）。MA组口咽和下咽气道横径及面积显著增加（P <.05），且在T3时增加稳定。在MAMS组，鼻咽气道横径和面积减小（P >.05），但下咽横径和面积显著增加（P <.05）。MA组术后舌骨向上向前移动（P <.05），且在T3时移动稳定。
结论：MA可增宽口咽和下咽气道空间，上颌后退可缩窄鼻咽气道空间。长期观察发现口咽和下咽宽度存在一些复发情况。MA组舌骨向上向前移动。（C）2017美国口腔颌面外科医师协会
Purpose: To obtain good profiles, patients with severe skeletal Class II malocclusion require orthognathic surgery, which might change their airway space and, hence, influence their quality of sleep. The present study aimed to 1) determine the effect of different orthognathic surgeries on pharyngeal airway space and hyoid bone position in patients with skeletal Class II malocclusion and 2) evaluate the stability of changes in the pharyngeal airway space and hyoid bone position after orthognathic surgeries.Materials and Methods: Patients with severe skeletal Class II malocclusion who underwent mandibular advancement (MA) or mandibular advancement and maxillary setback (MAMS) were included in this retrospective cohort study. Changes in the pharyngeal airway space and hyoid bone position were evaluated as the primary outcome variables. Measurements were obtained before surgery (T1), 1 month after surgery (T2), and 2 years after surgery (T3) using Dolphin Imaging Software 11.0. Differences in measurements between T2 and T1 and between T3 and T1 were calculated and imported into SPSS 22.0 for data analysis.Results: Fifty patients were included (25 in MA group and 25 in MAMS group). Oropharyngeal and hypopharyngeal airway cross-dimensions and areas were significantly increased in the MA group (P < .05) and the increases were stable at T3. In the MAMS group, the nasopharyngeal airway cross-dimension and area were decreased (P > .05), but the hypopharyngeal cross-dimension and area were significantly increased (P < .05). The hyoid bone moved superiorly and forward after surgery in the MA group (P < .05), and the movement was stable at T3.Conclusions: MA can widen the oropharyngeal and hypopharyngeal airway space, and maxillary setback can narrow the nasopharyngeal airway space. Some relapse related to the width of the oropharynx and hypopharynx was found at the long-term observation. The hyoid bone moved superiorly and forward in the MA group. (C) 2017 American Association of Oral and Maxillofacial Surgeons