Computerized tomographic evaluation of effects of mandibular anterior repositioning on the upper airway: a pilot study☆
Section snippets
Material and methods
Fifteen subjects with a chief complaint of snoring were referred to the Department Clinic of Oral and Maxillofacial Surgery at Ondokuz Mayis University and included in this study. Snoring history was obtained from either a spouse or a close relative. The criteria for exclusion included pregnancy, unstable or decompensated cardiopulmonary disease, including myocardial infarction, airway cancers, recent upper-airway surgery, tracheostomy,35 and upper and lower airway infections. After obtaining
Results
The subjects' ages varied from 22 to 58 years (mean age 38.6). The mean BMI was 27.4 kg/m2 (range between 21.3 and 31.9 kg/m2). The subjects were predominantly preobese (66.6%) and smokers (66.6%) (Table II). Two of the patients had nasal septum deviation and 1 subject had maxillary sinusitis.
The results of the statistical analysis are shown in Table III. When the AMP was inserted, MCSA-OPh increased by 60 mm2 on average (P<.05). This increase was observed in 86.6% of the subjects. Of those 13
Discussion
The results of the present study indicated that the primary effect of anterior mandibular positioning was on the oropharyngeal airway, resulting in airway enlargement owing to the tongue moving forward with the mandible. Similar results were reported in the literature.2., 6., 14., 15., 16., 18., 27. In the present study, it was observed that MCSA-OPh increased by 72.1% when AMP was inserted. Similarly, Johnson et al28 reported that posterior airway space increased by 56% in OSA patients on
Conclusions
Based upon the results of this pilot study, it was concluded that the primary effect of AMP is on the enlargement of the oropharyngeal airway. The ratio of the amount of mandibular advancement necessary to increase the posterior airway space was approximately was 2.4 to 1.
Acknowledgements
The authors thank Professor Hüseyin Akan, Department of Radiology, Medical Hospital of Ondokuz Mayıs University, for his support in this research project.
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Presented at the XVI Congress of the European Association for Cranio-Maxillofacial Surgery, Münster, Germany, September 2002.