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Intra-Operative Neural Monitoring of Thyroid Surgery in a Porcine Model

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Do Patients Detect Changes in Breathing After Orthognathic Surgery?

David Pellby¹, Martin Bengtsson²

¹Consultant Dentomaxillofacial Radiology, Department of Imaging and Function, Skåne University Hospital, Lund, Sweden.

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons

|October 20, 2023

Summary

Orthognathic surgery changes upper airway volume (UAV), but these changes were not linked to improved quality of life in asymptomatic patients. Patient-reported outcomes are most valuable when patients perceive a functional impairment before surgery.

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Area of Science:

Oral and Maxillofacial Surgery
Plastic Surgery
Health Outcomes Research

Background:

Orthognathic surgery corrects dentofacial deformities, potentially altering upper airway volume (UAV).
The impact of UAV changes on patient-reported benefits in asymptomatic individuals is not well understood.

Purpose of the Study:

To investigate the association between changes in upper airway volume (UAV) and patient-reported benefits after orthognathic surgery.
To utilize patient-reported outcome measures (PROMs) to assess these associations.

Main Methods:

Retrospective study of 54 patients (aged 18-30) undergoing orthognathic surgery for dentofacial deformities without prior breathing issues.
Changes in UAV were measured via 3D computed tomography; health-related quality of life was assessed using the Oral Health Impact Profile 49 (OHIP-49).
Statistical analyses included t-tests and Spearman's rank correlation, with adjustments for covariates like BMI.

Main Results:

No significant association was found between changes in UAV and overall patient-reported health-related quality of life (OHIP-49 scores).
While 50% of subjects experienced increased UAV, and 50% decreased UAV, both groups reported similar OHIP-49 scores post-surgery.
Patients with increased UAV showed a smaller improvement in OHIP-49 scores compared to those with decreased UAV, potentially due to baseline differences.

Conclusions:

Changes in upper airway volume following orthognathic surgery were not demonstrably linked to improvements in patient-reported quality of life in this asymptomatic cohort.
PROMs for evaluating orthognathic surgery outcomes, particularly for airway-related benefits, should focus on patients who report pre-existing functional impairments.