Comparison of airway changes after maxillomandibular advancement with or without genial tubercle advancement in obstructive sleep apnea using cone-beam computed tomography.

Introduction: This study compared the airway changes of patients with obstructive sleep apnea (OSA) after maxillomandibular advancement (MMA) with or without genial tubercle advancement (GTA) using cone-beam computed tomography.

Methods: The authors retrospectively studied 26 patients with moderate to severe OSA who underwent MMA with or without GTA. Airway changes were determined from preoperative and postoperative 3-dimensional reconstructed cone-beam computed tomography images. The Wilcoxon signed rank test, Mann-Whitney U tests, and Spearman correlation coefficients were used in data analysis.

Results: Airway was changed in all dimensions significantly after MMA with or without GTA. There was no significant difference in horizontal surgical changes between MMA and MMA with the GTA group. The mean increase in total airway volume was 66.8% for MMA alone and 74.7% for MMA with GTA (P = 0.39). Patients who underwent MMA had a larger percentage change of segmented upper airway volume than patients with MMA and GTA (106.6% vs 85.3%; P = 0.65). The group with MMA and GTA had a greater percentage change of segmented lower airway volume than the MMA alone group (80.1% vs 56.3%; P = 0.42).

Conclusions: Differences in airway changes between MMA alone and MMA with GTA were not statistically significant. Performing the GTA concomitantly with MMA may not cause greater improvement in the pharyngeal airway in patients with OSA compared with MMA alone.