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Changes in difficult airway predictors following mandibular setback surgery.

S S Soydan1, B Bayram1, B S Akdeniz2

  • 1Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Baskent University, Ankara, Turkey.

International Journal of Oral and Maxillofacial Surgery
|July 25, 2015
PubMed
Summary

Surgical mandibular setback surgery (SSRO) in skeletal class III patients can increase the Mallampati score, a predictor of difficult airways. Limit mandibular setback in patients with high preoperative scores to prevent potential airway issues.

Keywords:
Mallampati scoredifficult airway predictorsorthognathic surgerysagittal split ramus osteotomy

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Anesthesiology
  • Airway Management

Background:

  • Skeletal class III malocclusion often requires surgical correction.
  • Mandibular setback surgery can impact airway predictors.
  • Understanding these impacts is crucial for patient safety.

Purpose of the Study:

  • To evaluate the effect of surgical mandibular backward movement on difficult airway predictors.
  • To assess changes in Mallampati score, BMI, and airway distances post-SSRO.

Main Methods:

  • Thirty-seven skeletal class III patients underwent SSRO.
  • Mallampati score, BMI, inter-incisal, thyromental, and sternomental distances were measured preoperatively and postoperatively (6 months, 2 years).
  • Statistical analysis included paired t-tests and Wilcoxon signed-rank tests.

Main Results:

  • No significant changes in BMI, thyromental, or sternomental distances were observed.
  • Maximal inter-incisal distance decreased at 6 months but returned to baseline by 2 years.
  • A statistically significant increase in Mallampati score was noted postoperatively.

Conclusions:

  • Mandibular setback surgery can increase the Mallampati score, potentially indicating a more difficult airway.
  • Patients and practitioners must be aware of this increased risk.
  • Limiting mandibular setback in patients with high preoperative Mallampati scores is recommended to mitigate airway risks.