PHARYNGEAL AIRWAY VOLUME FOLLOWING ...

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surgery, and this change appeared to be stable up to one year following surgery. Introduction Combined orthodontic-orthognathic surgical treatment has made it possible to treat skeletal and dental dysplasias in patients where orthodontics alone cannot produce a desirable result. By altering the position of the jaws, the size and shape of the external and internal surrounding soft tissues are affected, including the pharyngeal airway, which could influence respiration. One of the goals of orthognathic surgery is to maintain or increase the size of the pharyngeal airway as not to predispose a patient to obstructive sleep apnea. 1 For sleep apnea patients, surgical advancement of both the maxilla and mandible is often performed to intentionally increase the size of the pharyngeal airway 2 to alleviate or reduce symptoms of the disorder. Obstructive sleep apnea is known to affect approximately 2-4% of middle-age adult women and men, respectively. 3 Risk factors include smoking, excessive alcohol consumption, snoring, obesity, 4 and increased neck circumference. 5 When compared to normal controls, apneic 24
patients often have elongated soft palates, large tongues, retrusive tongue positions, retrognathic maxillas and mandibles, retrusive chins, short anterior cranial bases, long anterior facial heights, inferiorly positioned hyoid bones, narrow posterior airway spaces, and narrowed lateral pharyngeal walls. 6-14 In patients with sleep apnea, it is known that the surrounding soft tissues and musculature of the airway can collapse or constrict during sleep in the oropharyngeal region of the airway. 15 Sites of airway collapse and constriction are not identical in all patients, and some have multiple sites of obstruction. 16 Treatment for obstructive sleep apnea consists of non- surgical and surgical therapies. Non-surgical modalities include weight loss, nasal continuous positive airway pressure (CPAP), and dental appliances. 15 Surgical treatments include, but are not limited to, uvulopalatopharygoplasty (UPPP), laser midline glossectomy, lingualplasty, radiofrequency volumetric tissue reduction, inferior sagittal mandibular osteotomy and genioglossal advancement, hyoid myotomy and suspension, and maxillomandibular advancement (MMA). 17 Advancement osteotomies of both the maxilla and the mandible have traditionally been considered when non- 25
Page 1 and 2: PHARYNGEAL AIRWAY VOLUME FOLLOWING
Page 3 and 4: PHARYNGEAL AIRWAY VOLUME FOLLOWING
Page 5 and 6: ACKNOWLEDGEMENTS I would like to th
Page 7 and 8: LIST OF TABLES Table 3.1: Descripti
Page 9 and 10: CHAPTER 1: INTRODUCTION Combined or
Page 11 and 12: CHAPTER 2: REVIEW OF THE LITERATURE
Page 13 and 14: the posterior pharyngeal wall, 2 or
Page 15 and 16: mask discomfort, nasal dryness, and
Page 17 and 18: Tongue-Reduction Procedures Other s
Page 19 and 20: structures causes the airway muscle
Page 21 and 22: after surgery, the upper retropalat
Page 23 and 24: skeletal tissues, soft tissues, and
Page 25 and 26: Literature Cited 1. Schwab RJ, Gold
Page 27 and 28: 19. Wittels EH, Thompson S. Obstruc
Page 29 and 30: 37. Li KK, Guilleminault C, Riley R
Page 31: CHAPTER 3: JOURNAL ARTICLE Abstract
Page 35 and 36: subsequent to orthognathic surgery
Page 37 and 38: years. Females had a mean age of 28
Page 39 and 40: Line from Sella to PNS Posterior of
Page 41 and 42: Line from Maxillary Incisor to Post
Page 43 and 44: counterclockwise rotation of the ma
Page 45 and 46: Table 3.1: Descriptive Statistics f
Page 47 and 48: Volume (cubic mm) 30000.00 25000.00
Page 49 and 50: percent change from T0 to T2 (r=.55
Page 51 and 52: surrounding soft tissues encroachin
Page 53 and 54: the pre-surgical values, but there
Page 55 and 56: Conclusions 1. In this study, patie
Page 57 and 58: 10. Lyberg T, Krogstad O, Djupeslan
Page 59 and 60: 27. Li KK, Powell NB, Riley RW, Tro

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