Avaliação radiográfica da influência da mentoplastia no espaço aéreo faríngeo em pacientes submetidos a avanço maxilomandibular

• Autor(a) principal: Torres, Hianne Miranda de
• Data de Publicação: 2014
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UFG
• dARK ID: ark:/38995/00130000098rb
• Texto Completo: http://repositorio.bc.ufg.br/tede/handle/tede/4929
• topic: Cefalometria; Cirurgia ortognática; Faringe; Cephalometry; Orthognathic surgery; Pharynx; ODONTOLOGIA::CLINICA ODONTOLOGICA

The aim of this study was to compare the changes in pharyngeal airway space (PAS) in patients undergoing orthognathic surgery for maxillomandibular advancement with genioplasty for advancement (surgery type I) or without genioplasty (surgery type II). The sample consisted of 52 patients (27 underwent surgery type I, 9 men and 18 women, with mean age of 30.81 years, and 25 patients underwent surgery type II, 9 men and 16 women, mean age 37.64 years) who underwent surgery between the years 2008 and 2012. To quantify the horizontal and vertical changes of the maxilla, mandible and mentum occurring after orthognathic surgery, comparisons were performed on lateral cephalometric radiographic exams preoperatively (TL1) and postoperatively (TL2) for the location of Point A (A), Point B (B) and pogonion (Pog), using as reference a vertical line (VL) tangent to the posterior portion of the Axis and Sela - Nasion line (SN). The PAS was measured from the posterior nasal spine (PNS), the lowest point of the soft palate (SPL) and epiglottic vallecula (V), using as reference the posterior pharyngeal wall (PPW) and the SN line. The measurements were performed on CliniView software (Instrumentarium, Tuusula, Finland). The collected data were statistically analyzed using SPSS 17.0 software (SPSS Inc., Illinois, USA). Statistically significant differences were found when comparing the TL1 and TL2 in PAS for variables PNS-PPW (P = 0.021), SPL-PPW (P = 0.003) and V-PPW (P = 0.010) for surgery type I and PNS-PPW (p < 0.001), SPL-PPW (p = 0.002) for surgery Type II (paired t-test). For horizontal and vertical changes in the maxilla, mandible and mentum were no statistically significant differences when comparing the TL1 and TL2 for the variables A-VL (p = 0.006), B-VL (p = 0.004), Pog-VL (p < 0.001), B-SN (p = 0.010) and Pog-SN (p = 0.041) for surgery Type I and A-VL (p = 0.001), B-VL (p < 0.001) Pog-VL (p = 0.003), B-SN (p = 0.001) and Pog-SN (p = 0.016) for surgery Type II (paired t test). In comparing the surgeries Type I and II, in relation to measurements of PAS, no statistically significant difference was found (t-test). For horizontal and vertical changes on maxilla, mandible and mentum no statistically significant differences were present for B-SN (p < 0.001) and Pog-SN (p = 0.002) (t-test). The Pearson correlation test was performed to test the correlation between changes on maxilla, mandible and mentum structures and PAS. Statistically significant correlations were found in B-VL/SPL-PPW (r = 0.484 and p = 0.011) and Pog-SN/V-PPW (r = 0.434 and p = 0.024) for surgery type I and B-VL/SPL-PPW (r = 0.509, p = 0.009) Pog-VL/V-PPW (r = 0.586, p = 0.002) and Pog-SN/V-PPW (r = 0.455, p = 0.022) for surgery Type II. Based on the results, was possible to conclude that the two surgeries are able to increase PAS, with no statistically significant difference between them, but the numbers pointed to a greater mean value gains in surgery type II (without genioplasty) in the nasopharynx and oropharynx and surgery type I (with genioplasty) in the hypopharynx region.