Maxillofac Plast Reconstr Surg.  2017 Aug;39(8):22. 10.1186/s40902-017-0120-6.

The structural changes of pharyngeal airway contributing to snoring after orthognathic surgery in skeletal class III patients

• Park JE
• Bae SH
• Choi YJ
• Choi WC
• Kim HW
• Lee UL

• KMID: 2416225
• DOI: http://doi.org/10.1186/s40902-017-0120-6

Abstract

BACKGROUND
Two-jaw surgery including mandibular and maxillary backward movement procedures are commonly performed to correct class III malocclusion. Bimaxillary surgery can reposition the maxillofacial bone together with soft tissue, such as the soft palate and the tongue base. We analyzed changes of pharyngeal airway narrowing to ascertain clinical correlations with the prevalence of snoring after two-jaw surgery.
METHODS
A prospective clinical study was designed including a survey on snoring and three-dimensional (3D) computed tomography (CT) in class III malocclusion subjects before and after bimaxillary surgery. We conducted an analysis on changes of the posterior pharyngeal space find out clinical correlations with the prevalence of snoring.
RESULTS
Among 67 subjects, 12 subjects complained about snoring 5 weeks after the surgical correction, and examining the 12 subjects after 6 months, 6 patients complained about the snoring. The current findings demonstrated the attenuation of the largest transverse width (LTW), anteroposterior length (APL), and cross-sectional area (CSA) following bimaxillary surgery given to class III malocclusion patients, particularly at the retropalatal level. The average distance of maxillary posterior movements were measured to be relatively higher (horizontal distance 3.9 mm, vertical distance 2.6 mm) in case of new snorers.
CONCLUSIONS
This study found that bimaxillary surgery could lead to the narrowing of upper airway at the retropalatal or retroglossal level as well as triggering snoring in subjects with class III malocclusion. Based on the current clinical findings, we also found that upper airway narrowing at retropalatal level may contribute to increasing the probability of snoring and that polysonography may need to be performed before orthognathic surgery in subjects with class III malocclusion.

Keyword

Bimaxillary surgery; Class III malocclusion; Obstructive sleep apnea; Posterior airway space; Snoring

MeSH Terms

Clinical Study
Humans
Malocclusion
Orthognathic Surgery*
Palate, Soft
Prevalence
Prospective Studies
Sleep Apnea, Obstructive
Snoring*
Tongue