Effects of orthognathic surgery on oropharyngeal airway: a meta-analysis

Oropharyngeal changes caused by orthognathic surgery have been a concern because the sleep quality of patients may be enhanced or worsened by these changes. The purpose of this meta-analysis was to identify, review and compare scientific literature about changes in airway in adult patients undergoing orthognathic surgery to correct anteroposterior osseous discrepancies. An electronic search of four databases was carried out up to July 2010, with supplemental hand searching of the references of the retrieved articles. Quality assessment of the included articles was carried out. Data were extracted and a meta-analysis was performed. Heterogeneity was assessed amongst the studies and results were presented in forest plots. 49 studies met the inclusion criteria. Only studies with moderate or high methodological soundness were included in the review. Moderate evidence was found to support a significant decrease in the oropharyngeal airway in mandibular setback surgery, a milder decrease in bimaxillary surgery to correct Class III and an increase in maxillomandibular advancement surgery. Evidence is lacking on airway volume changes after orthognathic surgery.