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Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned...
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Upper airway changes following high oblique sagittal split osteotomy (HSSO).

Julia von Bremen1, Jan-Hendrik Lotz2, Wolfgang Kater2

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Journal of Cranio-Maxillo-Facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery
|January 11, 2021
PubMed
Summary

Bimaxillary surgery significantly increased posterior airway space (PAS) in Class II patients but maintained it in Class III patients. This study evaluated volumetric changes using cone beam CT scans after high oblique sagittal split osteotomy.

Keywords:
Airway managementOrthognathic surgical proceduresSagittal split ramus osteotomy

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Area of Science:

  • Orthodontics and Maxillofacial Surgery
  • Respiratory Physiology
  • Medical Imaging

Background:

  • Bimaxillary surgery is a common orthodontic procedure.
  • Changes in posterior airway space (PAS) volume can impact respiratory function.
  • The high oblique sagittal split osteotomy (HSSO) is a specific surgical technique.

Purpose of the Study:

  • To evaluate volumetric changes in the posterior airway space (PAS) after bimaxillary surgery using HSSO.
  • To compare PAS changes between Class II and Class III patients.
  • To analyze the impact of HSSO on total and segmented PAS volumes.

Main Methods:

  • Cone beam computed tomography (CBCT) scans were analyzed before (T0) and after (T1) surgery (6-12 months).
  • Three-dimensional software (Mimics® Innovation Suite 18.0) was used for volumetric analysis.
  • PAS was divided into superior, middle, and inferior segments for detailed assessment.

Main Results:

  • Class II patients showed significant increases in total PAS (+33.6%), middle PAS (+43.1%), and inferior PAS (+55.9%).
  • Class III patients exhibited a statistically significant increase only in the superior PAS (+9.7%), with non-significant changes in total, middle, and inferior PAS.
  • HSSO technique resulted in significant PAS expansion for Class II and preservation for Class III patients.

Conclusions:

  • HSSO bimaxillary surgery effectively increases PAS volume in Class II patients.
  • The HSSO technique appears to maintain PAS volume in Class III patients.
  • Volumetric assessment of PAS is crucial for understanding surgical outcomes in orthognathic surgery.