Effects of orthognathic surgery on pharyngeal/oropharyngeal airway in adults: A systematic review of systematic reviews

• Author Details:   
• Jeenal Manglani
• Aayushi Chauhan ^*
• Rakesh Mohode
• Rajan K Mahindra

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Introduction: Orthognathic surgery is a commonly employed surgical intervention for the correction of dentofacial deformities, and its impact on the upper airway is of clinical significance. Such surgeries can also alter tongue position which can further alter the upper airway. This review synthesizes findings from multiple systematic reviews to provide a comprehensive overview of the current knowledge base.
Aim and Objectives: To study the effects of maxillary advancement or setback, mandibular advancement or setback or combination of above surgeries on pharyngeal/oropharyngeal airway in adults pharyngeal airway dimension and tongue position.
Materials and Methods: A systematic search was conducted in major databases, including Ovid, PubMed and Embase. The inclusion criteria encompassed systematic reviews that evaluated the impact of orthognathic surgery on pharyngeal or oropharyngeal airway dimensions, with a focus on adult populations. The quality of the included reviews was assessed using the R-AMSTAR tool. Data extraction was done only for medium and high-quality reviews.
Results: The search yielded a total of 8 reviews meeting the inclusion criteria and satisfied the quality appraisal. The reviews collectively examined a diverse range of orthognathic surgical procedures and their effects on the airway. Our review showed that there is an increase in airway dimensions post maxillomandibular advancement (MMA), and a decrease post mandibular setback surgery and a decrease in airway to a lesser extent when mandibular setback was combined with maxillary advancement.
Conclusion: Although clinical evidence indicates a potential augmentation in airway dimensions following MMA, and decrease after setback, there is an imperative need for further research employing controlled methodologies. Additionally, there is a necessity for studies that standardize both follow-up periods and imaging techniques to ensure more robust and comparable findings across investigations.