Pharyngeal airway changes five years after bimaxillary surgery: A retrospective study

Sivaranjani Madhan, Michael Boelstoft Holte, Alexandru Diaconu, Jens Jørgen Thorn, Janne Ingerslev, Gustavo G. Nascimento, Marie Cornelis, Else Marie Pinholt*, Paolo M. Cattaneo

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review


The aim of this study was to retrospectively evaluate pharyngeal airway (PA) changes after bimaxillary surgery (BMS).

Preoperative, immediate- and 5-year postoperative cone-beam computed tomography images of subjects who underwent BMS were assessed. The primary outcome variable was the PA volume. The secondary outcome variables were the retropalatal and oropharyngeal volumes, cross-sectional area, minimal hydraulic diameter, soft tissue, skeletal movements and sleep-disordered breathing (SDB).

A total of 50 patients were included, 33 female and 17 male, with a mean age of 26.5 years. A significant increase in the PA volume was seen immediately after surgery (40%), and this increase was still present at 5-year follow-up (34%) (P < 0.001). A linear mixed model regression analysis revealed that a mandibular advancement of ≥5 mm (P = 0.025) and every 1-mm upward movement of epiglottis (P = 0.016) was associated with a volume increase of the oropharyngeal compartment. Moreover, ≥5-mm upward movement of hyoid bone (P = 0.034) and every 1-mm increase in minimal hydraulic diameter (P < 0.001) correlated with an increase of the PA volume. A total of 30 subjects reported improvement in the SDB at 5-year follow-up.

This study demonstrated that BMS led to an increase in PA dimensions in non-OSA patients, and these changes were still present at 5-year follow-up. BMS seemed to induce clinical improvement in SDB.
Original languageEnglish
JournalJournal of Cranio-Maxillofacial Surgery
Issue number11
Pages (from-to)848-857
Publication statusPublished - Nov 2022


  • Computer-assisted surgery
  • Cone-beam computed tomography
  • Orthognathic surgery
  • Pharynx
  • Three-dimensional imaging
  • Orthognathic Surgical Procedures/methods
  • Humans
  • Malocclusion, Angle Class III/surgery
  • Male
  • Mandible/diagnostic imaging
  • Pharynx/diagnostic imaging
  • Adult
  • Female
  • Retrospective Studies
  • Cephalometry/methods
  • Cone-Beam Computed Tomography/methods


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