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Updated: Oct 23, 2025

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Are we able to predict airway dimensional changes in isolated mandibular setback?

M D Han1, F Antonini2, A M Borba3

  • 1Department of Oral and Maxillofacial Surgery, University of Illinois at Chicago, Chicago, Illinois, USA.

International Journal of Oral and Maxillofacial Surgery
|August 19, 2021
PubMed
Summary

This study found no correlation between mandibular setback surgery and changes in airway dimensions. Cone beam computed tomography (CBCT) measurements could not predict obstructive sleep apnea development after this procedure.

Keywords:
cone beam computed tomographymandibular osteotomyobstructive sleep apneaorthognathic surgerysagittal split ramus osteotomy

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Area of Science:

  • Orthognathic Surgery
  • Airway Physiology
  • Radiographic Imaging

Background:

  • Mandibular setback surgery, specifically bilateral sagittal split osteotomy, is performed to correct skeletal discrepancies.
  • Changes in upper airway dimensions following such procedures are a clinical concern, potentially impacting breathing.
  • Predicting airway modifications is crucial for patient outcomes and managing risks like obstructive sleep apnea.

Purpose of the Study:

  • To investigate the relationship between the extent of mandibular setback and alterations in upper airway volume and dimensions.
  • To determine if cone beam computed tomography (CBCT) measurements can predict airway changes after mandibular setback surgery.
  • To assess the association between the magnitude of mandibular setback and oropharyngeal and hypopharyngeal dimensions.

Main Methods:

  • Retrospective review of cone beam computed tomography (CBCT) scans and patient records.
  • Inclusion of patients who underwent isolated bilateral sagittal split osteotomy setback between 2013 and 2020.
  • Measurement of mandibular setback using six distinct methods and analysis of upper airway volume and minimum axial area.

Main Results:

  • No statistically significant association was found between the magnitude of mandibular setback and changes in oropharyngeal or hypopharyngeal volume.
  • Stepwise regression analysis did not reveal any significant relationships between setback amount and airway dimensions.
  • No correlation was observed between mandibular setback and the minimum axial area of the oropharynx or hypopharynx.

Conclusions:

  • The magnitude of mandibular setback does not correlate with static changes in airway dimensions.
  • Current CBCT measurements may not be sufficient to predict the development of obstructive sleep apnea after mild to moderate mandibular setback.
  • Further research may be needed to identify reliable predictors of airway compromise following orthognathic surgery.