Pharyngeal airway changes five years after bimaxillary surgery – A retrospective study

The pharyngeal airway (PA), which consists of a retropalatal and an oropharyngeal compartment, is dimensionally determined by the surrounding soft and hard tissues. Orthognathic surgery influences the PA in maxillofacial deformity patients due to hard and soft tissue repositioning, resulting in positional changes of the soft palate, tongue, pharyngeal tissues, and especially the hyoid bone (Gokce et al., 2014; Tseng et al., 2020; Giralt-Hernando et al., 2021). Clockwise rotation and mandibular setback result in a decreased volume of the PA (Gokce et al., 2014; Fernández-Ferrer et al., 2015; Wiedemeyer et al., 2019; Tseng et al., 2020). In contrast, advancement surgeries and counterclockwise rotations of the mandible increase the PA volume (Araujo et al., 2019; Giralt-Hernando et al., 2021; Pereira et al., 2021). Bimaxillary surgery (BMS) is becoming more popular due to improved oral function and facial appearance, as well as a reduced likelihood of causing airway obstruction, and is thus preferred over single-jaw surgeries (Hatab et al., 2015; Rossi et al., 2019; Souza Pinto et al., 2019).

The PA is a non-circular, tube-like structure, which is characterized by its volume, cross-sectional area, and hydraulic diameter (Niu et al., 2021). Various studies have analyzed the effect of orthognathic surgery on PA using cone-beam computed tomography (CBCT) (Burkhard et al., 2014; Gokce et al., 2014; Shin et al., 2015; Ristow et al., 2018; Gurani et al., 2019; Souza Pinto et al., 2019; Tseng et al., 2020; von Bremen et al., 2021). A thorough sift through the literature revealed that only few of the previous studies report more than two years follow-up (Shin et al., 2015; Araujo et al., 2019; Gurani et al., 2019; Pereira et al., 2021; von Bremen et al., 2021; Hassing et al., 2022). It seems that there is a need for future studies to include longer follow-up periods (Shokri et al., 2021), respiratory parameters (An et al., 2019), hyoid bone position (Shin et al., 2015), clinical subjective data (Lenza et al., 2010; Titiz et al., 2012; Zhou et al., 2016; Pereira et al., 2021; von Bremen et al., 2021), assessment of the clinical relevance of an enlarged PA after BMS (Giralt-Hernando et al., 2021; Pereira et al., 2021; von Bremen et al., 2021), and use of standardized, validated methods for measurement (Shokri et al., 2021).

The aims of this study were to evaluate PA morphological changes in dentofacial deformity patients immediately and 5 years after BMS.

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