Avaliação do espaço aéreo faríngeo em pacientes submetidos à cirurgia ortognática para avanço de mandibula

Orientador: Delson João da CostaMonografia (Especialização) - Universidade Federal do Paraná, Setor de Ciências da Saúd

TRATAMENTO DE FRATURA COMPLEXA DO RAMO MANDIBULAR. RELATO DE CASO

O tratamento das fraturas mandibulares complexas, ou seja, aquelas em que ocorre mais de um traço de fratura concomitantemente, representam um desafio para o cirurgião buco-maxilo-facial devido às altas taxas de complicações pós-operatórias. Este trabalho tem como objetivo apresentar através do relato de um caso clínico os princípios do tratamento de fraturas complexas da mandíbula. Um paciente de 17 anos, branco, gênero masculino, apresentou-se no Hospital XV após ter sofrido acidente ciclístico com traumatismo facial. Ao exame clínico o paciente apresentava edema na região de ângulo e ramo mandibular do lado esquerdo, parestesia do nervo alveolar inferior, alteração oclusal, limitação dos movimentos mandibulares e creptação óssea à manipulação. Aos exames de imagem foi confirmada a presença de fratura complexa do ramo mandibular do lado esquerdo. Instituiu-se tratamento cirúrgico através de acesso submandibular para redução e fixação dos segmentos ósseos fraturados, com controle da oclusão. Utilizou-se fixação interna rígida com 1 placa do sistema 2.3mm com parafusos bicorticais e 1 placa do sistema 2.0mm com parafusos monocorticais. O paciente encontra-se em acompanhamento ambulatorial, apresentando resultado final satisfatório tanto estético quanto funcional. A filosofia de tratamento bem como os resultados obtidos neste caso serão confrontados àqueles disponíveis na literatura.

Avaliação do espaço aéreo faríngeo em pacientes submetidos à cirurgia ortognática para avanço de mandibula

Orientador: Delson João da CostaMonografia (Especialização) - Universidade Federal do Paraná, Setor de Ciências da Saúd

Pharyngeal airspace in patients undergoing orthognathic surgery for mandibular advancement

Aim: To evaluate the increase of pharyngeal airway space (PAS) in patients undergoing mandibular advancement. Methods: A retrospective cross-sectional study was performed in thirteen patients who underwent mandibular advancement and were evaluated by cephalometric tracing in pre and postoperative lateral radiographs. In cephalometric tracing, the PAS was assessed by measuring the distance from the lower portion of the soft palate to the posterior pharyngeal wall (UP-PHW) and from the tongue base to the posterior pharyngeal wall (TB-PHW). Results: Patients’ age ranged from 22 to 42 years with an average of 28.54 ± 2.23 years. A preoperative mean of 9.20 ± 4.56 mm in the UP-PHW measure and 10.53 ± 5.84 mm in the TB-PHW measure were obtained. The mean values found for those measurements in the postoperative period were 11.61 mm and 13.95 mm, respectively. There was an average increase of 2.4 mm in the UP-PHW and of 2.95 mm in the TB-PHW. The mean mandibular advancement in evaluated patients was 5 mm. There was no statistical correlation between PAS increase and the amount of mandibular advancement for UP-PHW (p=0.058) and TB-PHW (p=0.53), as there was no such correlation either between PAS increase and the age of patients for UP-PHW (p=0.16) and TB-PHW (p=0.26). A greater effect of the retrolingual dimension in mandibular advancement was observed, with an average increase of 24.52% while in the retropalatal dimension an average increase of 20.75% was obtained. Conclusions: Surgical advancement of the mandible increases the size of the pharyngeal airway space

Pharyngeal airspace in patients undergoing orthognathic surgery for mandibular advancement

evaluate the increase of pharyngeal airway space (PAS) in patients undergoing mandibular advancement. Methods: A retrospective cross-sectional study was performed in thirteen patients who underwent mandibular advancement and were evaluated by cephalometric tracing in pre and postoperative lateral radiographs. In cephalometric tracing, the PAS was assessed by measuring the distance from the lower portion of the soft palate to the posterior pharyngeal wall (UP-PHW) and from the tongue base to the posterior pharyngeal wall (TB-PHW). Results: Patients age ranged from 22 to 42 years with an average of 28.54 ± 2.23 years. A preoperative mean of 9.20 ± 4.56 mm in the UP-PHW measure and 10.53 ± 5.84 mm in the TB-PHW measure were obtained. The mean values found for those measurements in the postoperative period were 11.61 mm and 13.95 mm, respectively. There was an average increase of 2.4 mm in the UP-PHW and of 2.95 mm in the TB-PHW. The mean mandibular advancement in evaluated patients was 5 mm. There was no statistical correlation between PAS increase and the amount of mandibular advancement for UP-PHW (p=0.058) and TB-PHW (p=0.53), as there was no such correlation either between PAS increase and the age of patients for UP-PHW (p=0.16) and TB-PHW (p=0.26). A greater effect of the retrolingual dimension in mandibular advancement was observed, with an average increase of 24.52% while in the retropalatal dimension an average increase of 20.75% was obtained. Conclusions: Surgical advancement of the mandible increases the size of the pharyngeal airway space