Evaluation of Airway Changes Following Isolated Unilateral mandibular Fracture: A Prospective Quasi-Experimental

Maxillofacial trauma presents unique airway management challenges due to anatomical disruptions, soft tissue compromise, edema, hemorrhage, and emesis. While isolated mandibular fractures are typically non-emergent, specific fracture patterns can precipitate airway obstruction secondary to bony fragment displacement. There is a paucity of data on airway changes after unilateral mandibular fractures. This prompted us to conduct the present study.

This prospective, quasi-experimental study enrolled patients with isolated unilateral mandibular fractures requiring surgical reduction between December 2023 and December 2024. Airway changes were assessed via lateral cephalometric analysis pre-operatively and at a 3-month post-operative interval. Specifically, the distances of the posterior nasal spine (PSP), the intersection of the inferior border of the mandible with the posterior tongue (PTO), and the highest point of the epiglottis (E) from the PRL reference line (a vertical line connecting the Porion (PO) to the Frankfort plane) were measured and compared on pre- and post-operative cephalometric radiographs. Descriptive and bivariate statistics were employed, with statistical significance defined as P < 0.05.

Twenty eight patients, including 18 males and 10 females with a mean age of 34.4 ± 14.1 years, were investigated. Post-treatment, the average airway space increased slightly at all measured points: PSP (23.6 mm to 23.8 mm, P=0.222), PTO (22.0 mm to 22.1 mm, P=0.366), and E (12.6 mm to 12.9 mm, P=0.590).

Although slight increases in airway space were observed post-treatment at all measured points (PSP, PTO, and E), none of these changes were statistically significant.