Pharyngeal airway morphology in healthy individuals and in obstructive sleep apnea patients treated with maxillomandibular advancement: a comparative study

• Published in: Oral surgery, oral medicine, oral pathology and oral radiology oral medicine, oral pathology and oral radiology, 2015-03, Vol.119 (3), p.285-292
• Main Authors: Butterfield, Kevin J., DDS, MD, Marks, Patricia L.G, McLean, Laurie, MD, Newton, Jack, DDS
• Format: Article
• Language: English
• Subjects: Adult; Case-Control Studies; Cephalometry; Cone-Beam Computed Tomography; Dentistry; Female; Humans; Male; Mandibular Advancement - methods; Maxilla - diagnostic imaging; Maxilla - surgery; Osteotomy, Le Fort; Osteotomy, Sagittal Split Ramus; Pharynx - anatomy & histology; Pharynx - diagnostic imaging; Pharynx - surgery; Polysomnography; Retrospective Studies; Sleep Apnea, Obstructive - diagnostic imaging; Sleep Apnea, Obstructive - surgery; Surgery; Treatment Outcome
• ISSN: 2212-4403; 2212-4411
• DOI: 10.1016/j.oooo.2014.11.016

Objective This study investigated the differences in airway morphology between control patients and those with obstructive sleep apnea (OSA) treated with maxillomandibular advancement (MMA) to gain better insight into the beneficial effects of MMA on airway morphology and OSA severity. Study Design This retrospective case-control study included preoperative radiographic data gathered for all patients; postoperative radiographic data were gathered for the OSA group. Statistical analysis, including the Student t test, and simple linear regression was performed to identify differences in cephalometric and airway variables among the three groups and to associate airway morphology to disease severity. Results Twenty-four patients (12 with OSA; 12 controls) treated at the same clinic were included in this study. Statistically significant differences versus control values were found for preoperative total airway volume, postoperative airway length, and both pre- and postoperative airway minimum cross-sectional areas. In general, the untreated OSA airway was anatomically compromised in comparison with controls, whereas the treated airway showed significant morphologic improvements, comparable with the control group values. Conclusions MMA produces statistically significant airway improvements for OSA patients, producing airway morphology comparable with that of the controls. However, some degree of residual OSA may still exist. Therefore, factors other than static airway morphology contribute to OSA pathogenesis.