A three-dimensional comparison of the pharyngeal airway after mandibular distraction osteogenesis and bilateral sagittal split osteotomy

Abstract

Purpose: The goal of this retrospective study was to examine the radiological changes in the pharyngeal airway following mandibular distraction osteogenesis (DO) and bilateral sagittal split osteotomy (BSSO).

Material and methods: Between 2005 and 2009, a total of 41 nonsyndromic patients underwent a mandibular osteotomy (nDO = 23; nBSSO = 18). Digital volume tomography images were created for preoperative and postoperative evaluations of both groups. The Dolphin 3D program was used for comparative analysis of the pharyngeal airways.

Results: After DO, the airway volumes (VOL) improved by 6.8 mL. In comparison, an improvement of 5.9 mL was observed as result of BSSO. The minimum axial areas (AREA) of the enlargements increased by 109.1 mm(2) with DO and 103.1 mm(2) with BSSO. The airway areas (SA) increased by 193.8 mm(2) with DO and 185.2 mm(2) with BSSO. There were no significant differences between two surgical procedures in terms of the parameters describe above (pVOL = 0.358; pAREA = 0.752; pSA = 0.777). However, the initial preoperative values (pVOL = 0.020; pAREA = 0.005) and the patients' ages (pAREA = 0.042; pSA = 0.007) did have significant effects on the postoperative values.

Conclusion: Both DO and BSSO expanded the pharyngeal airways of all nonsyndromic patients.

Keywords: Airway change; Bilateral sagittal split osteotomy; Mandibular distraction osteogenesis; Orthognathic surgery; Pharyngeal airway; Upper airway.