Changes in nasal resistance and air way structure associated with orthognathic surgery.

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The purpose of this study was to investigate the respiratory physiological and morphological effects of orthognathic surgery (Obwegeser Dalpon't method) on nasal resistance and upper pharyngeal air way structure.On experiment 1, the change of nasal resistance in postoperative period was investigated in thirteen patients who underwent nasal endtracheal intubation, and the nasal resistance was measured by the mask anterior method for every day after extubation.On experiment 2, materials were composed of pre and postoperative lateral cephalogram of ten individuals.The statistical results and subjective appraisal suggest the following conclusions :1. On the intubated side, the nasal resistance was decreased immediately after extubation due to mechanical pressure of the endotracheal tube, and increased on the next day. After 2nd post operative day, it returned to the preoperative value, and it did not change any more.2. On the not intubated side, the nasal resistance increased just after extubation, and decreased on next day.3. There was no significant change in total resistance and fiber scopic finding for the perioperative period.4. The nasal resistance of obstructed side was severly decreased after intra-nasal administration of tramazoline HCI.5. The width of pharyngeal air way was slightly decreased anteroposteriorly but this was much smaller than the amount of chin retraction associated with operation.6. The area of pharyngeal air way was slightly decreased but this was not indicate air way obstruction immediately after extubation.The findings in the present studies indicate the safty of air way in post-operative period and suggested the attention should be paid to the management of air way for two days after operation.