Pharyngeal Airway and Craniocervical Angle among Different Skeletal Patterns (original) (raw)
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Evaluation of pharyngeal airway space amongst different skeletal patterns
International Journal of Oral and Maxillofacial Surgery, 2012
The aim of the present study was to evaluate the dimensions of the pharyngeal airway space (PAS) in awake, upright children with different anteroposterior skeletal patterns using cone beam computed tomography (CBCT). The volume, area, minimum axial area and seven linear measurements of PAS were obtained from the CBCT images of 50 children (mean age 9.16 years). The patients were divided in two groups according to the ANB angle (group I 28 ANB 58; group II ANB > 58). Means and standard deviations of each variable were compared and correlated using independent t-test and Pearson's correlation test. There were statistically significant differences in the following parameters: angle formed by the intersection between NA and NB lines (p < 0.001), angle formed by the intersection between SN and NB lines (p < 0.05), Minimal pharyngeal airway space between the uvula and the posterior pharyngeal wall (p < 0.05), airway volume (p < 0.01), airway area (p < 0.01) and minimum axial area (p < 0.05). The anteroposterior cephalometric variable SNB had positive correlation with the variables PAS-UP (p < 0.01), Minimal pharyngeal airway space between the uvula tip and the posterior pharyngeal wall (p < 0.05), Pharyngeal airway space on mandibular line (p < 0.05), Minimal pharyngeal airway space between the back of the tongue and the posterior pharyngeal wall (p < 0.05), volume airway (p < 0.05), airway area (p < 0.05) and minimum axial area (p < 0.05). The vertical cephalometric variables angle formed by the intersection between SN and GoGn lines (p < 0.05) and angle formed by the intersection between FH and mandible plane (p < 0.05) showed negative correlation with PAS-UT. These results showed that PAS was statistically larger in group I than group II, indicating that the dimensions of the PAS are affected by different anteroposterior skeletal patterns.
Journal of Indian Orthodontic Society, 2015
Human beings are normally nasal breathers. The nasal and the oral cavities serve as pathways for respiratory airflow, however in some individuals due to nasal airway inadequacy or habit; the oral cavity becomes the predominant route for the respiratory airflow. [1] Changes in the dimensions of the respiratory tract that is, constriction can cause a decrease in airflow at times. [2] There are significant relationships between the pharyngeal dimensions and craniofacial abnormalities. [3] Literature supports the notion that mandibular deficiency is frequently associated with a narrower pharyngeal airway passage. [4] Using computed tomography (CT), Trenouth and Timms [5] found that the effects of rapid maxillary expansion (RME) on the nasal cavity are not uniform and the changes in the nasal dimensions are progressively less toward the back of the nasal cavity. Mean cross-sectional nasal cavity enlargements of between 1.4 and 4 mm for rapid expansion, 0.8 mm for a quad helix, and 0.5 mm for a removable appliance have been reported. [6,7] According to Saitoh, [8] the growth of the face (excluding the mandible) is completed at a relatively early age. Sixty percent of craniofacial development takes place during the first 4 years of life and 90% by age 12. Based on these observations, any intervention to open the airway must take place at an early
Pharyngeal Airway Space Dimensions and Hyoid Bone Position in Various Craniofacial Morphologies
2021
To assess the relationship of pharyngeal airway dimensions and the position of the hyoid bone in several craniofacial morphologies among Nepali adults. To assess the relationship between dimensions of the pharyngeal airway and position of the hyoid bone and compare gender dimorphism. The cross-sectional observational research comprised lateral cephalograms of 150 subjects aged 16 to 30 years. Samples were separated into three sagittal craniofacial morphological groups based on the ANB (A point, nasion, B point) angle and into gender groups. Different parameters (linear and angular) for measuring dimensions of the pharyngeal airway and position of the hyoid bone were assessed. An ANOVA test and a Pearson correlation test were performed. Dimensions of the pharyngeal airway were largest in skeletal Class III when compared to skeletal Class I and Class II subjects, with a lower pharyngeal airway space and the length of the nasal fossa being significantly larger. The hyoid bone was anter...
American Journal of Orthodontics and Dentofacial Orthopedics, 2013
The objective of this study was to characterize the volume and the morphology of the pharyngeal airway in adolescent subjects, relating them to their facial skeletal pattern. Methods: Fifty-four subjects who had cone-beam computed tomography were divided into 3 groups-skeletal Class I, Class II, and Class IIIaccording to their ANB angles. The volumes of the upper pharyngeal portion and nasopharynx, and the volume and morphology of the lower pharyngeal portion and its subdivisions (velopharynx, oropharynx, and hypopharynx) were assessed with software (version 11.5; Dolphin Imaging & Management Solutions, Chatsworth, Calif). The results were compared with the Kruskal-Wallis and the Dunn multiple comparison tests to identify intergroup differences. Correlations between variables assessed were tested by the Spearman correlation coefficient. Correlations between the logarithms of airway volumes and the ANB angle values were tested as continuous variables with linear regression, considering the sexes as subgroups. Results: The minimum areas in the Class II group (112.9 6 42.9, 126.9 6 45.9, and 142.1 6 83.5 mm 2) were significantly smaller than in Class III group (186.62 6 83.2, 234.5 6 104.9, and 231.1 6 111.4 mm 2) for the lower pharyngeal portion, the velopharynx, and the oropharynx, respectively, and significantly smaller than the Class I group for the velopharynx (201.8 6 94.7 mm 2). The Class II group had a statistically significant different morphology than did the Class I and Class III groups in the velopharynx. There was a tendency to decreased airway volume with increased ANB angle in the lower pharyngeal portion, velopharynx, and oropharynx. In the upper pharyngeal portion, nasopharynx, and hypopharynx, there seemed to be no association between the airway volume and the skeletal pattern. Conclusions: The Class II subjects had smaller minimum and mean areas (lower pharyngeal portion, velopharynx, and oropharynx) than did the Class III group and significantly less uniform velopharynx morphology than did the Class I and Class III groups. A negative correlation was observed between the ANB value and airway volume in the lower pharyngeal portion and the velopharynx (both sexes) and in the oropharynx (just in male subjects). (Am J Orthod Dentofacial Orthop 2013;143:799-809) T he upper airway is a structure responsible for one of the main vital functions in the human organism-breathing. The interest in studying the upper airway has always been present in orthodontics, and 1 main objective is to clarify the relationship between pharynx structures and craniofacial complex growth and development. 1-4 Obstructive processes of morphologic, physiologic, or pathologic nature, such as hypertrophy of adenoids and tonsils, chronic and allergic rhinitis, irritant environmental factors, infections, congenital nasal deformities, nasal traumas, polyps, and tumors, are predisposing factors to a blocked upper airway. When that happens, a functional imbalance results in an oral breathing pattern that can alter facial morphology and dental arch forms, generating a malocclusion. 2,5,6 Considering the functional matrix theory proposed by Moss, 7 the association of respiratory and masticatory functions and swallowing might act on craniofacial development.
PHARYNGEAL AIRWAY SPACE IN DIFFERENT SKELETAL MALOCCLUSION AND FACIAL FORMS
Background: Evaluation of the upper and lower airway space should be an integral part of diagnosis and treatment planning to achieve the functional balance and stability of the result after orthodontic or orthognathic treatment. This study aimed to analyze the pharyngeal airway space in different skeletal malocclusion and facial forms. Methods: Study was carried out in lateral cephalometric radiographs of 210 patients. Data was collected from March 2021 to December 2021. Pharyngeal airway spaces were analyzed according to McNamara Analysis. Upper and lower pharyngeal airway in different skeletal malocclusion and facial form was determined. Data was analyzed in SPSS version 20. Independent samples-t test was applied for gender distribution and Pearson correlation test was applied for upper and lower pharyngeal space. Results: The mean value of upper pharyngeal airway width in Class I, II and III were 12.07 mm, 11.57 mm and 12.34 mm respectively and for Mesofacial, Dolichofacial and Brachyfacial facial form were 12.35 mm, 11.83 mm and 11.81 mm respectively. Similarly, the mean value for lower pharyngeal airway width in Class I, II and III were 9.51 mm, 9.13 mm and 10.03 mm respectively and for Mesofacial, Dolichofacial and Brachyfacial facial form were 9.62 mm, 9.34 mm and 9.61mm respectively. Male had higher value of mean lower pharyngeal width than female. Conclusions: There was no impact of sagittal skeletal malocclusion on the upper and lower airways width. Also, there was no impact of different vertical skeletal types or facial forms on the upper and lower airways width.
Children
Background: The pharyngeal airway is a crucial part of the respiratory system’s function. Assessing the pharyngeal airway dimensions in different skeletal types is important in the orthodontic treatment of growing patients. The aim of this study was to compare the upper pharyngeal airway dimensions of 7–14-year-old children with different skeletal types. Methods: Three-hundred-sixty-one lateral cephalometric radiographs were grouped based on their skeletal patterns determined by the ANB angle as skeletal type I (n = 123), type II (n = 121), and type III (n = 117). The radiographs were divided into 4 groups: 7/8 YO (7–8 years old), 9/10 YO, 11/12 YO, and 13/14 YO. The cephalometric measurements comprised SNA, SNB, ANB, Ad1-PNS, Ad2-PNS, McUP, and McLP. An ANOVA was used to compare the group results. Results: Significant differences in Ad1-PNS, Ad2-PNS, McUP, and McLP in skeletal types II and III were found between age groups. Most upper pharyngeal airway dimensions in skeletal types ...
Cephalometrics of Pharyngeal Airway Space in Lebanese Adults
International Journal of Dentistry
Purpose. The upper airway space is significant in orthodontic diagnosis and treatment planning. The objectives of this study are to assess the dimensions of soft tissue elements of the upper pharyngeal space and evaluate potential correlations with modifying variables such as gender, skeletal class, and anthropometric parameters.Materials and Methods. Lateral cephalograms were obtained from 117 healthy young adult Lebanese subjects. Nineteen cephalometric linear/angular measurements of the nasopharynx, oropharynx, and hypopharynx were recorded. Anthropometric parameters including body mass index and neck circumference were measured.Results. Significant differences were demonstrated for 12 out of the 19 parameters considered between genders. Uvula and tongue dimensions and the distances between epiglottis-posterior pharyngeal wall and epiglottis-posterior nasal spine were significantly larger in males. The anteroposterior inclination of the uvula and the distances between the uvula a...
Journal of Indian Orthodontic Society, 2012
Objectives: To test the hypothesis that there is no association between sagittal maxillomandibular relationship and pharyngeal airway passage dimensions. Materials and methods: Lateral cephalograms of 90 subjects were used to measure the upper pharyngeal airway. The subjects were divided into three groups (each group included 30 subjects) according to ANB angle: Class III (ANB < 0.7°); Class I (ANB > 0.7° and < 4.7°); Class II (ANB > 4.7°). All lateral cephalograms were traced manually. Results: The results showed a significant reduction in the upper airway at the level of nasopharynx and oropharynx and the airway showed a tendency to decrease from Class III to Class I and Class I to Class II. Conclusion: Sagittal skeletal pattern had a close association between the pharyngeal airway passage and the dimensions of the pharyngeal airway passage. The dimensions of pharyngeal airway passage were decreased from Class III to Class I and Class I to Class II subjects.
American Journal of Orthodontics and Dentofacial Orthopedics, 2010
In growing patients with skeletal discrepancies, early diagnosis, evidence-based explanations of etiology, and assessment of functional factors can be vital for the restoration of normal craniofacial growth and the stability of the treatment results. The aims of our study were to compare the 3-dimensional pharyngeal airway volumes in healthy children with a retrognathic mandible and those with normal craniofacial growth, and to investigate possible significant relationships and correlations among the studied cephalometric variables and the airway morphology in these children. Methods: Three-dimensional airway volume and crosssectional areas of 27 healthy children (12 boys, 15 girls; mean age, 11 years) were measured by using cone-beam computed tomography volume scans, and 2-dimensional lateral cephalograms were created and analyzed. The subjects were divided into 2 groups based on their ANB angles (group I: 2 # ANB # 5 ; group II: ANB .5), and cephalometric variables, airway volumes, and cross-sectional measurements were compared. Results: There were statistically significant differences in the following parameters: height of the posterior nasal plane (P \0.05), pogonion to nasion perpendicular distance (P \0.01), ANB angle (P \0.01), mandibular body length (P \0.01), facial convexity (P \0.01), and total airway volume (P \0.05). No statistically significant differences between the 2 groups were found in the cross-sectional area and the volumetric measurements of the various sections of the airway except for total airway volume, which had larger values in group I (P \0.05). Conclusions: The mean total airway volume, extending from the anterior nasal cavity and the nasopharynx to the epiglottis, in retrognathic patients was significantly smaller than that of patients with a normal anteroposterior skeletal relationship. On the other hand, differences in volume measurements of the 4 subregions of the airway were not statistically significant between the 2 groups.