Prospective Analysis of the Swallowing Reflex After Sagittal Split Osteotomy: Comparison with Normal Volunteers
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ORIGINAL ARTICLE
Prospective Analysis of the Swallowing Reflex After Sagittal Split Osteotomy: Comparison with Normal Volunteers Aysenur Genc1 · Sabri Cemil Isler1 · Cengizhan Keskin1 · Ali Emre Oge2 · Zeliha Matur3 Received: 13 March 2019 / Accepted: 3 December 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract The aim of this study was electromyographic description of changes in swallowing before and after bilateral sagittal split ramus osteotomy. In this prospective study, twenty-eight patients were divided into 3 groups according to the occlusion pattern: Group I (Angle Class III), Group II (Angle Class II), and Control (Class I). Serial cone-beam computed tomography analyses and electromyographic data were collected preoperatively, 1st and 6th months after setback surgery in Group I, and advancement surgery in Group II. Swallowing reflex with 3–20 ml water bolus were studied. Patients were further divided into two subgroups according to the magnitude of relapse. The mean setback of the mandible was 4.62 ± 1.92 mm in Group I, and the mean advancement was 4.19 ± 2.00 mm in Group II. Mandibular relapse rate was 17.40%. Oral preparation phase shortened after surgery in both study groups. Two subjects in Group II and one in Group I had piecemeal deglutition, and two of them became normal postoperatively. Most of the swallowing durations of the relapsed cases were longer than those of stabilized patients. Important clinical considerations are as follows: the oral preparation period becomes shorter after surgery; piecemeal deglutition may disappear after treatment; and individuals with a longer oral period and piecemeal deglutition may have increased tendency to skeletal relapse. This multidisciplinary study enhances our understanding of the adaptive response to the swallowing reflex after orthognathic surgery and provides novel insight into the association between the submental muscle activity and relapse in orthognathic patients. Keywords Sagittal split osteotomy · Dentofacial deformity · Swallowing reflex · Electromyography · Deglutition · Deglutition disorders
Introduction Skeletal malocclusions can be managed with surgical manipulations of dentofacial apparatus. Bilateral sagittal split osteotomy (BSSO) is routinely used as an orthognathic surgical procedure to treat mandibular deformities. Mandibular surgical intervention improves the occlusion and skeletal position of the mandible and oropharyngeal complex [1]. There is a close inter-relationship between the soft tissue profile and skeletal structures. The sagittal, vertical, or transverse * Aysenur Genc [email protected] 1
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
2
Department of Neurology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
3
Department of Neurology, Faculty of Medicine, Istanbul Bilim University, Istanbul, Turkey
orientation of the mandible inevitably involves shortening or elongation of adjacent soft tissue stru
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