*Dr. Renu Datta
**Dr. Ashok Utreja
***Dr. S P Singh
****Dr. Vidya Rattan
The Journal
Cephalometric evaluation of airway changes after
distraction osteogenesis of mandible
Objective: To evaluate changes in the oropharyngeal airway using cephalometric evaluation after
mandibular distraction osteogenesis.
Material and methods: This study was conducted on 13 patients with faciomandibular deformity
requiring surgical and orthodontic intervention for correction. Mean age of the patients was 18.6
years (range 10 to 31 years). Pre-distraction and post-distraction cephalometric radiographs were
evaluated using specific landmarks to evaluate airway changes.
Results: Analysis of the results showed that mean change in the airway was 3.77mm at the level of
soft palate, 2.69mm at the level of tongue, 1.39mm at the level of lower pharyngeal wall and
epiglottis, 2.73mm in the pharyngeal depth at 2nd cervical vertebra and 1.65mm in pharyngeal depth
at the 4th cervical vertebra. There was significant change in airway space at all the levels of
measurements. In patients with bilateral mandibular distraction, statistically significant (p<0.05)
increase in the airway space occurred at the level of soft palate (4.18mm), tongue (4.17mm) and the
pharyngeal depth at 2nd cervical vertebra (2.25mm). In patients who underwent unilateral
mandibular distraction, statistically significant change occurred at the level of soft palate (3.22mm)
and pharyngeal depth at 2nd cervical vertebra. (3.14mm). Functional improvements were noted in all
patients.
Conclusion: Our findings reveal that significant changes in the oropharyngeal airway occur after
mandibular distraction osteogenesis. This is relevant when attempting to evaluate patients with
retrognathia and airway obstruction and for predicting the changes with respect to distraction
osteogenesis of the mandible.
Introduction
Facial deformity can lead to physical, functional
and psychological problems for the
[1,2]
individual . It may occur due to abnormality of
the maxillae, the mandible or the entire
craniofacial complex. Retarded growth and
development of the mandible leads to
retrognathia or micrognathia. It may occur as a
result of growth disturbances during the peri-
natal period when associated with syndromes
such as the Pierre-Robin anomaly, or may be
secondary to traumatic injuries of the
temporomandibular joint which lead to
[3]
ankylosis and subsequent growth retardation .
Other than obvious facial deformity and
functional limitations related to reduced jaw
size, retrognathia has also been associated
with posterior positioning of the tongue, leading
to reduced oro-pharyngeal airway space [4,5] .
Distraction osteogenesis of the jaw bones has
been shown to be an acceptable method of
improving hard and soft tissue profiles of the
[6]
maxillofacial region .Distraction of the
mandible also leads to associated changes in
the oro-pharyngeal musculature, and has been
successfully performed to improve airway
obstruction as well . However, objective data
analyzing such soft tissue changes is limited.
* Professor and Head, Department of Orthodontics, Sri Sukhmani Dental College and Hospital, Punjab, India.
** Former Professor and Head, Oral Health Sciences Center and Head, Unit of Orthodontics and Craniofacial Orthopedics, PGIMER, Chandigarh.
*** Professor and Head, Department of Orthodontics, Oral Health Sciences Center, PGIMER, Chandigarh.
**** Professor and Head, Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Center, PGIMER, Chandigarh.
51
Vol. 14 No. 1
Jan-Apr 2018