下颌支矢状骨劈开术后退下颌治疗骨性Ⅲ类错𬌗畸形对上气道和睡眠呼吸通气功能的影响

doi:10.13591/j.cnki.kqyx.2025.02.008

Abstract

Abstract:

Objective To examine the effects of SSRO (sagittal split ramus osteotomy) for Class Ⅲ malocclusion treatment on pharyngeal airway space (PAS) and respiratory function during sleep. Methods The subjects were 18 patients in whom mandibular prognathism was corrected by sagittal split ramus osteotomy. Morphological changes were studied using cone beam computed tomography at 3 days before surgery and 6 months after surgery. 3D models of the craniofacial and pharyngeal airway morphology were reconstructed with a 3D image analysis system (Mimics Innovation Suite). The anteroposterior dimension, lateral width, cross-sectional area of each subject’s pharyngeal airway were measured before and after surgery. The three airway volumes and total PAS volume were measured before and after surgery. Single polysomnography (PSG) monitoring was performed using the polysomnography system 3 days before and 6 months after orthognathic surgery, respectively, and the monitoring data were recorded. Statistical analysis of the data was performed using SPSS 25.0 software package. Results SP-AP and SP-CSA decreased after operation (P<0.05). EP-AP was significantly decreased (P<0.01)and EP-CSA decreased (P<0.05). The oropharynx volume and total PAS volume were significantly decreased, and the epiglottic volume decreased (P<0.05). There were no significant changes in respiratory function during sleep. Conclusion SP-AP, SP-CSA, EP-AP, EP-CSA, the oropharynx volume, the epiglottic volume and total PAS volume were decreased significantly after surgery. There were no significant changes in respiratory function during sleep.

Key words: sagittal split ramus osteotomy, Class Ⅲ malocclusion, CBCT, pharyngeal airway volume, polysomnography, respiratory function during sleep

CLC Number:

R783.5

MA Hui, WANG Wen, QIU Yan, HUA Zequan. The effect of SSRO of Class Ⅲ malocclusion on the pharyngeal airway and respiratory function during sleep[J]. Stomatology, 2025, 45(2): 123-128.

Figures/Tables 4

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References 34

[1]	Havron AG, Aronovich S, Shelgikar AV, et al. 3D Airway changes using CBCT in patients following mandibular setback surgery± maxillary advancement[J]. Orthod Craniofac Res, 2019, 22(Suppl1): 30-35.
[2]	Shokri A, Ramezani K, Afshar A, et al. Upper airway changes following different orthognathic surgeries, evaluated by cone beam computed tomography: A systematic review and meta-analysis[J]. J Craniofac Surg, 2021, 32(2): 147-152.
[3]	Steegman R, Hogeveen F, Schoeman A, et al. Cone beam computed tomography volumetric airway changes after orthognathic surgery: A systematic review[J]. Int J Oral Maxillofac Surg, 2022, 52(1): 60-71.
[4]	曲潇茹, 谢明吉, 刘东旭. 骨性Ⅲ类患者手术先行治疗后上气道及其周围组织变化的三维评价[J]. 中华口腔正畸学杂志, 2020, 27(1): 40-44.
[5]	Lee ST, Park JH, Kwon TG. Influence of mandibular setback surgery on three-dimensional pharyngeal airway changes[J]. Int J Oral Maxillofac Surg, 2019, 48(8): 1057-1065.
[6]	Ronchi P, Saccomanno S, Disconzi B, et al. Upper airway changes and OSAS risk in patients after mandibular setback surgery to treat Ⅲ Class skeletal malocclusion[J]. J Pers Med, 2023, 13(7): 1105.
[7]	Karaaslan S, Tüz HH, El H, et al. Three-dimensional evaluation of upper airway changes after bimaxillary surgery of skeletal Class Ⅲ Patients[J]. J Craniofac Surg, 2023, 34(3): 996-1000.
[8]	Lee JY, Kim YI, Hwang DS, et al. Effect of maxillary setback movement on upper airway in patients with Class Ⅲ skeletal deformities: Cone beam computed tomographic evaluation[J]. J Craniofac Surg, 2013, 24(2): 387-391.
[9]	Khaghaninejad MS, Khojastehpour L, Danesteh H, et al. Changes in the pharyngeal airway after different orthognathic procedures for correction of Class Ⅲ dysplasia[J]. Maxillofac Plast Reconstr Surg, 2022, 44(1): 23. doi: 10.1186/s40902-022-00352-8 pmid: 35678935
[10]	宋丹, 孙健, 李亚莉, 等. 骨性Ⅲ类错𬌗畸形正颌手术对上气道容积的影响[J]. 精准医学杂志, 2021, 36(4): 327-330.
[11]	Becker OE, Avelar RL, Göelzer JG, et al. Pharyngeal airway changes in Class Ⅲ patients treated with double jaw orthognathic surgery—maxillary advancement and mandibular setback[J]. J Oral Maxil Surg, 2012, 70(11): 639-647.
[12]	Kang NE, Lee DH, In Seo J, et al. Postoperative changes in the pharyngeal airway space through computed tomography evaluation after mandibular setback surgery in skeletal Class Ⅲ patients:1-year follow-up[J]. Maxillofac Plast Reconstr Surg, 2021, 43(1): 31. doi: 10.1186/s40902-021-00319-1 pmid: 34448114
[13]	Fatani B, Fatani O, Fatani A, et al. Changes in pharyngeal airway space and oxygen saturation following mandibular setback surgery: A narrative review[J]. Cureus, 2022, 14(11): 31178.
[14]	聂萍, 陶丽, 朱妍菲, 等. 2种不同正颌术式对骨性Ⅲ类错𬌗畸形患者上气道形态的影响.[J]. 上海口腔医学, 2018, 27(3): 280-284.
[15]	Kobayashi T, Funayama A, Hasebe D, et al. Changes in overnight arterial oxygen saturation after mandibular setback[J]. Br J Oral Maxillofac Surg, 2013, 51(4): 312-318. doi: 10.1016/j.bjoms.2012.07.004 pmid: 22853977
[16]	Foltán R, Hoffmannová J, Donev F, et al. The impact of Le Fort I advancement and bilateral sagittal split osteotomy setback on ventilation during sleep[J]. Int J Oral Maxillofac Surg, 2009, 38(10): 1036-1040.
[17]	Gokce SM, Gorgulu S, Gokce HS, et al. Changes in posterior airway space, pulmonary function and sleep quality, following bimaxillary orthognathic surgery[J]. Int J Oral Maxillofac Surg, 2012, 41(7): 820-829.
[18]	Park SB, Kim YI, Son WS, et al. Cone-bean computed tomography evaluation of short and long-term airway change and stability after orthognathic surgery in patients with Class Ⅲ skeletal deformities: Bimaxillary surgery and mandibular setback surgery[J]. Int J Oral Maxillofac Surg, 2012, 41(1): 87-93.
[19]	Yamada Y, Yamada M, Chubachi S, et al. Comparison of inspiratory and expiratory airway volumes and luminal areas among standing, sitting, and supine positions using upright and conventional CT[J]. Sci Rep, 2022, 12(1): 21315. doi: 10.1038/s41598-022-25865-0 pmid: 36494466
[20]	Uesugi T, Kobayashi T, Hasebe D, et al. Effects of orthognathic surgery on pharyngeal airway and respiratory function during sleep in patients with mandibular prognathism[J]. Int J Oral Maxillofac Surg, 2014, 43(9): 1082-1090.
[21]	Hong JS, Park YH, Kim YJ, et al. Three-dimensional changes in pharyngeal airway in skeletal Class Ⅲ patients undergoing orthognathic surgery[J]. J Oral Maxillofac Surg, 2011, 69(11): 401-408.
[22]	Jeong S, Sung J, Kim S, et al. Upper airway morphologic changes after mandibular setback surgery in skeletal Class Ⅲ malocclusion patients measured using cone beam computed tomography superimposition[J]. INT J Oral Max Surg, 2018, 47(11): 1405-1410.
[23]	Degerliyurt K, Ueki K, Hashiba Y, et al. A comparative CT evaluation of pharyngeal airway changes in Class Ⅲ patients receiving bimaxillary surgery or mandibular setback surgery[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2008, 105(4): 495-502. doi: 10.1016/j.tripleo.2007.11.012 pmid: 18329585
[24]	Kawamata A, Fujishita M, Ariji Y, et al. Three-Dimensional computed tomographic evaluation of morphologic airway changes after mandibular setback osteotomy for prognathism[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2000, 89(3): 278-287.
[25]	陈洁, 杨学明, 黄媛媛, 等. 运用多导睡眠监测(PSG)评估骨性Ⅲ类错𬌗畸形患者正颌手术后呼吸功能的变化[J]. 口腔医学, 2014, 34(6): 423-426.
[26]	Engboonmeskul T, Leepong N, Chalidapongse P. Effect of surgical mandibular setback on the occurrence of obstructive sleep apnea[J]. J Oral Biol Craniofac Res, 2020, 10(4): 597-602. doi: 10.1016/j.jobcr.2020.08.008 pmid: 32953442
[27]	Mazière S, Pépin JL, Siyanko N, et al. Usefulness of oximetry for sleep apnea screening in frail hospitalized elderly[J]. J Am Med Dir Assoc, 2014, 15(6): 9-14.
[28]	Kim SH, Choi SK. Changes in the hyoid bone, tongue, and oropharyngeal airway space after mandibular setback surgery evaluated by cone-beam computed tomography[J]. Maxillofac Plast Reconstr S, 2020, 42(1): 27.
[29]	Kim JW, Kwon TG. Why most patients do not exhibit obstructive sleep apnea after mandibular setback surgery?[J]. Maxillofac Plast Reconstr Surg, 2020, 42(1): 7.
[30]	Khor YH, Khung SW, Ruehland WR, et al. Portable evaluation of obstructive sleep apnea in adults:A systematic review[J]. Sleep Med Rev, 2023, 68: 101743.
[31]	Yavari N, Samieirad S, Labafchi A, et al. Is there an increase in the risk of obstructive sleep apnea after isolated mandibular setback surgery?An evaluation using the STOP-BANG questionnaire[J]. J Oral Max Surg, 2020, 78(11): 2061-2069.
[32]	On SW, Kim HJ, Cho DH, et al. Silent changes in sleep quality following mandibular setback surgery in patients with skeletal Class Ⅲ malocclusion:A prospective study[J]. Sci Rep, 2019, 9(1): 9737.
[33]	Pereira-Filho VA, Castro-Silva LM, de Moraes M, et al. Cephalometric evaluation of pharyngeal airway space changes in class Ⅲ patients undergoing orthognathic surgery[J]. J Oral Maxillofac Surg, 2011, 69(11): 409-415.
[34]	Hasebe D, Kobayashi T, Hasegawa M, et al. Changes in oropharyngeal airway and respiratory function during sleep after orthognathic surgery in patients with mandibular prognathism[J]. Int J Oral Maxillofac Surg, 2011, 40(6): 584-592.

测量项目	T0	T1	P
PNS-AP/mm	21.53±3.89	21.54±3.88	0.946
PNS-W/mm	29.09±2.18	28.90±2.24	0.120
PNS-CSA/mm²	478.00±104.76	476.58±106.92	0.862
SP-AP/mm	13.54±1.40	12.76±1.31	0.024^*
SP-W/mm	28.24±4.86	28.17±4.92	0.073
SP-CSA/mm²	389.56±109.48	335.91±97.81	0.015^*
EP-AP/mm	16.25±2.11	14.80±1.97	0.006^*
EP-W/mm	35.93±4.10	35.30±4.43	0.239
EP-CSA/mm²	346.90±69.88	318.14±52.60	0.028^*
V_鼻咽区/mm³	9 401.33±723.62	9 274.55±1 104.25	0.640
V_口咽区/mm³	11 548.30±5 901.21	9 518.67±4 853.60	0.003^**
V_会厌区/mm³	21 251.58±8 898.72	20 911.26±8 607.68	0.024^*
V_总/mm³	42 232.52±10 315.39	39 996.62±9 155.68	0.005^**

测量项目	T0	T1	P
AHI	0.52±0.72	0.48±0.61	0.691
睡眠效率	89.38±8.99	89.52±8.18	0.631
平均血氧饱和度	97.80±1.00	97.67±0.81	0.439
最低血氧饱和度	94.75±1.87	94.65±1.81	0.417

The effect of SSRO of Class Ⅲ malocclusion on the pharyngeal airway and respiratory function during sleep

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