Abstract：
The posterior airway space (PAS) is a common site of passive obstructions with high morbidity. Surgical changes to the craniomandibular system may affect the PAS. Data regarding the effects of mandibular reconstruction using vascularized bone flaps on PAS are insufficient. This retrospective cohort study aimed to investigate changes in PAS after mandibular reconstruction.
Pre- and post-reconstructive computed tomography scans of 40 patients undergoing segmental mandibulectomy and mandibular reconstruction with deep circumflex iliac artery or fibula flaps were analyzed. Absolute differences in PAS geometry and relative trends of PAS volume changes were compared within the study population and between subgroups formed according to the extent of resection, timing and type of reconstruction, and presence of pre-reconstructive radiotherapy.
Irradiated patients were characterized by an increase in PAS volume after reconstruction. Absolute differences in total PAS volume after reconstruction were significantly different (p = 0.024) compared to non-irradiated patients. Reconstruction of central mandible segments resulted in decrease of the cross-sectional PAS areas. Absolute differences in middle cross-sectional PAS area after reconstruction were significantly different (p = 0.039) compared to non-central reconstructions. Patients who received radiotherapy were less likely to show a total PAS volume reduction after reconstruction (OR: 0.147; p = 0.007), with values adjusted for gender, age, body mass index, timing and type of reconstruction, and transplant length.
Mandibular reconstruction causes changes in PAS geometry. Specifically, reconstructions of central mandibular segments can lead to a reduction in the cross-sectional areas of PAS, and mandibular reconstructions in irradiated sites may cause an increase in PAS volume.
Pre- and post-reconstructive computed tomography scans of 40 patients undergoing segmental mandibulectomy and mandibular reconstruction with deep circumflex iliac artery or fibula flaps were analyzed. Absolute differences in PAS geometry and relative trends of PAS volume changes were compared within the study population and between subgroups formed according to the extent of resection, timing and type of reconstruction, and presence of pre-reconstructive radiotherapy.
Irradiated patients were characterized by an increase in PAS volume after reconstruction. Absolute differences in total PAS volume after reconstruction were significantly different (p = 0.024) compared to non-irradiated patients. Reconstruction of central mandible segments resulted in decrease of the cross-sectional PAS areas. Absolute differences in middle cross-sectional PAS area after reconstruction were significantly different (p = 0.039) compared to non-central reconstructions. Patients who received radiotherapy were less likely to show a total PAS volume reduction after reconstruction (OR: 0.147; p = 0.007), with values adjusted for gender, age, body mass index, timing and type of reconstruction, and transplant length.
Mandibular reconstruction causes changes in PAS geometry. Specifically, reconstructions of central mandibular segments can lead to a reduction in the cross-sectional areas of PAS, and mandibular reconstructions in irradiated sites may cause an increase in PAS volume.
摘要：
背景：后气道间隙（PAS）是被动阻塞的常见部位，发病率高。颅下颌系统的手术改变可能会影响PAS。有关使用血管化骨瓣对PAS进行下颌骨重建的影响的数据不足。这项回顾性队列研究旨在研究下颌骨重建后PAS的变化。
方法：分析了40例接受节段性下颌骨切除术和下颌骨重建术的患者行旋髂深动脉或腓骨皮瓣的重建前后的计算机断层扫描扫描。在研究人群中以及根据切除程度形成的亚组之间，比较了PAS几何形状的绝对差异和PAS体积变化的相对趋势。重建的时间和类型，以及重建前放疗的存在。
结果：照射患者的特征是重建后PAS体积增加。与未照射患者相比，重建后总PAS体积的绝对差异显着（p=0.024）。重建中央下颌骨节段导致横截面PAS面积减少。与非中心重建相比，重建后中间横截面PAS面积的绝对差异显着（p=0.039）。接受放疗的患者在重建后不太可能显示总的PAS体积减少（OR：0.147；p=0.007），根据性别调整了值，年龄,身体质量指数,重建的时间和类型，和移植长度。
结论：下颌骨重建导致PAS几何结构的改变。具体来说,下颌中央节段的重建可导致PAS横截面积的减少，受照射部位的下颌重建可能会导致PAS体积增加。
方法：分析了40例接受节段性下颌骨切除术和下颌骨重建术的患者行旋髂深动脉或腓骨皮瓣的重建前后的计算机断层扫描扫描。在研究人群中以及根据切除程度形成的亚组之间，比较了PAS几何形状的绝对差异和PAS体积变化的相对趋势。重建的时间和类型，以及重建前放疗的存在。
结果：照射患者的特征是重建后PAS体积增加。与未照射患者相比，重建后总PAS体积的绝对差异显着（p=0.024）。重建中央下颌骨节段导致横截面PAS面积减少。与非中心重建相比，重建后中间横截面PAS面积的绝对差异显着（p=0.039）。接受放疗的患者在重建后不太可能显示总的PAS体积减少（OR：0.147；p=0.007），根据性别调整了值，年龄,身体质量指数,重建的时间和类型，和移植长度。
结论：下颌骨重建导致PAS几何结构的改变。具体来说,下颌中央节段的重建可导致PAS横截面积的减少，受照射部位的下颌重建可能会导致PAS体积增加。
