Pharyngeal Airway Space Changes After Condylar Replacement and Mandibular Advancement Surgery

Publication date: Available online 3 January 2018
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Holly Yuen, P. Emile Rossouw, Larry M. Wolford, Hongyue Wang
PurposeThe aim of this study was to examine the total volume and cross-sectional areas of the pharyngeal airway after bilateral condylar replacement and mandibular advancement surgery.Materials and Methods137 subjects (126 females, 11 males) had bilateral TMJ total joint replacement by one surgeon. A subsample of 30 subjects who had condylar replacement and only mandibular advancement were evaluated for impact on airway. Measurements were taken pre-operatively, post-operatively, and at a follow-up one year after surgery on CBCTs. InVivoDental 3D imaging was used to measure airway space with regards to total volume (cm³), minimum cross-sectional area (mm²), minimum cross-sections of the first, second, and third cervical vertebrae, and if the subject had mandibular retrognathia prior to surgery. A second operator was used to test for inter-operator error. Descriptive and bivariate statistics were computer and the P-value was set at 0.05.ResultsThere was a significant increase in all measurements at the follow-up visit compared to the pre-op visit. There were no significant differences between groups based on simultaneous Le Fort I surgery, mandibular retrognathia, and gender. However, there were statistically significant differences in cross-section 1 & 2 as well as minimum cross-sectional area with regards to age. Condylar replacement and mandibular advancement has a significant association with an increase in airway space. The intra-class correlation coefficient showed excellent agreement between inter-operator measurements.ConclusionsPatients undergoing bilateral TMJ replacement and mandibular advancement surgery show an increase in pharyngeal airway space at a one-year follow-up. In this study, age is found to be significantly associated with cross-sectional areas of the airway, with older patients having smaller values.



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