Pharyngeal Airway Changes Following Bimaxillary Orthognathic Surgery in Asian Patients

This study aimed to investigate the changes of the pharyngeal airway dimensions in Southeast Asian patients with dentofacial deformities after bimaxillary orthognathic surgery. Forty-seven Southeast Asian patients (mean age 26.3) with dentofacial deformities scheduled for bimaxillary orthognathic surgery treated at the University of Hong Kong were included. Preoperative and postoperative Cone Beam Computed Tomography (CBCT) scans quantified total and regional airway volumes (velopharyngeal, oropharyngeal, and epiglottic) and cross-sectional metrics, including minimum cross-sectional area (mCSA), its anteroposterior and transverse dimensions, and mean cross-sectional area. At baseline, class II patients had significantly smaller and narrower airways than class III (volume P=0.030; width P<0.001) and narrower than class I (P=0.004). Postoperatively, class II showed significant airway enlargement: total volume increased by 4.4 cm³ (24.5%) and mCSA by 0.8 cm² (71.7%). Class I and class III exhibited smaller, nonsignificant changes. No group experienced a postoperative decrease in airway space, and postsurgery total airway size did not differ significantly among classes. Airway changes did not differ between single-piece and multisegmental procedures. In this Asian cohort, bimaxillary orthognathic surgery significantly enlarged the pharyngeal airway in class II patients, while class I and III showed no significant changes. The surgical segmentation approach did not influence airway outcomes.