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Three-Dimensional Morphological Changes in the Upper Airway After Maxillary Reconstruction With an Anterolateral Thigh Flap.
- Source :
-
Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons [J Oral Maxillofac Surg] 2024 Aug 10. Date of Electronic Publication: 2024 Aug 10. - Publication Year :
- 2024
- Publisher :
- Ahead of Print
-
Abstract
- Background: Reconstruction of maxillary defects may lead to changes in the upper airway. These changes may cause postoperative airway obstruction issues.<br />Purpose: The purpose was to evaluate the postoperative changes in the upper airway following maxillary reconstruction with an anterolateral thigh flap (ALTF) and to identify the factors associated with these changes.<br />Study Design, Setting, Sample: This retrospective cohort study involved 26 patients who underwent maxillectomy for maxillary tumors, followed by reconstruction using an ALTF. Patients with a history of upper respiratory system disease and sleep-disorder breathing were excluded.<br />Predictor Variable: The predictor variable was the residual rate of ALTF volume (ALTF-RS), calculated as the ratio of ALTF volume at 6 months postsurgery (T2) to that at 2 weeks postsurgery (T1).<br />The Outcome Variables: The outcome variables were the upper airway parameters. The upper airway was assessed at 3 time points: 1 week preoperatively (T0), T1, and T2. Ratios were used to represent airway changes over time.<br />Covariates: The covariates are age, sex, Brown classification, body mass index, hypertension, neck dissection, and tracheostomy, etc. ANALYSES: Airway measurement differences between the three time points were analyzed by one-way analysis of variance. Pearson correlation and Spearman correlation analysis were used to analyze the correlation coefficients between airway changes and ALTF-RS. Statistical significance was established at a P value < .05.<br />Results: The sample included 26 subjects with a mean age of 55.6 ± 15.2 years and 15/26 (57.7%) were male. Compared to T0, the nasopharyngeal and retropalatal airway volumes at T1 significantly decreased (P < .05) but recovered or surpassed preoperative levels by T2. The minimum cross-sectional airway area significantly decreased by T1 (P < .05), but increased by T2 (P < .05). The narrowest airway section was predominantly in the palatopharyngeal airway. The airway changes of T2/T1 and ALTF-RS were not correlated (P > .05) except for anterior-inferior point of the 4th cervical vertebra cross-sectional area (P < .05).<br />Conclusion and Relevance: The volumetric changes in the airway were not associated with ALTF-RS. The substantial narrowing of minimum cross-sectional airway area at T1 emphasized the need for vigilant airway management in these patients.<br /> (Copyright © 2024 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)
Details
- Language :
- English
- ISSN :
- 1531-5053
- Database :
- MEDLINE
- Journal :
- Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons
- Publication Type :
- Academic Journal
- Accession number :
- 39208869
- Full Text :
- https://doi.org/10.1016/j.joms.2024.08.003