The “Rubber Band” and “Slingshot” Effects of the Posterior Airway Space in Mandibular Orthognathic Surgeries

Abstract

Introduction: Mandibular surgeries are the most common orthognathic procedures that are undertaken. The pharyngeal airway space (PAS) is influenced by the changes in the sagittal changes of the mandible. Mandibular advancement surgeries are used to an advantage in obstructive sleep apnea cases to improve the airway space. On the contrary, there can be a considerable decrease in the airway space during mandibular setback procedures. Numerous studies have been conducted to study the effect of changes in the PAS during mandibular procedures. However, a combined radiographic and endoscopic analysis of the airway space has been sparsely done in recent literature Materials and methods: Thirty-one patients with mandibular discrepancies who needed mandibular surgeries were chosen. The assessment of PAS was done using both lateral cephalograms and endoscopic examination. Results: As lateral cephalograms can study only the two-dimensional changes in the PAS, endoscopic examination both pre operatively and post operatively enabled the exact assessment of mandibular surgeries on the PAS. The PAS responds to setback mandibular surgery by modifying itself- called the “Rubber band” effect and in advancement surgeries as “Slingshot effect”.