Effect of Mandibular Advancement Surgery on Tongue Length and Height and Its Correlation with Upper Airway Dimensions
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ORIGINAL ARTICLE
Effect of Mandibular Advancement Surgery on Tongue Length and Height and Its Correlation with Upper Airway Dimensions N. K. Sahoo1 • Shiv Shankar Agarwal2 • Sanjeev Datana2 • S. K. Bhandari1
Received: 22 August 2019 / Accepted: 16 April 2020 Ó The Association of Oral and Maxillofacial Surgeons of India 2020
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). & N. K. Sahoo [email protected] 1
Department of Oral and Maxillofacial Surgery, Armed Forces Medical College, Pune, India
2
Department of Orthodontics and Dentofacial Orthopedics, Armed Forces Medical College, Pune, India
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. Keywords Mandibular advancement (MA) Obstructive sleep apnea (OSA) Airway BSSRO
Introduction Orthognathic surgeries involving maxilla and/or mandible are mainly performed for bringing about positive improvement in facial and smile aesthetics of the patient apart from correction of various facial deformities [1, 2]. Maxillomandibular advancement by orthognathic surgery/ distraction osteogenesis (DO) is a well-documented treatment modality for the management of obstructive sleep apnea (OSA) secondary to hypoplastic/retruded maxilla and/or mandible. This treatment modality brings positive improvement in airway by causing physical expansion of the pharyngeal hard and soft tissues [3]. The surgeries involving mandibular setback (MS) are well known to cause detrimental effects on upper airway [4, 5]. The literature reveal
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