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<p>Mandibular retrognathism in skeletal Class II malocclusion is frequently associated with narrowing of the pharyngeal airway space (PAS), predisposing patients to compromised respiratory function and obstructive sleep apnoea (OSA). Mandibular advancement surgery has been proposed to improve airway dimensions; however, existing clinical evidence remains fragmented and largely descriptive. To quantitatively evaluate the effectiveness of mandibular advancement surgery on pharyngeal airway dimensions through a systematic review and meta-analysis of three-dimensional imaging-based evidence. The review was conducted in accordance with the PRISMA guidelines and registered in PROSPERO. Electronic searches were performed in PubMed, Scopus, Web of Science, and Google Scholar from January 2000 to September 2025. Eligible studies included prospective, retrospective, and controlled clinical studies assessing the impact of isolated mandibular advancement on airway volume and cross-sectional dimensions using computed tomography (CT) or cone-beam computed tomography (CBCT). Primary outcomes included total airway volume, segmental volumes of the nasopharynx, oropharynx, and hypopharynx, and minimum cross-sectional area (mCSA). Study quality and risk of bias were assessed using standardized tools. The systematic review included clinical studies involving adult skeletal Class II patients undergoing isolated mandibular advancement surgery. Meta-analysis revealed a statistically significant increase in total pharyngeal airway volume postoperatively, with the most pronounced expansion observed in the oropharyngeal region. The mCSA also showed significant improvement, indicating reduced airway collapsibility. Available longitudinal studies demonstrated maintenance of airway gains at one-year follow-up with minimal relapse. Considerable heterogeneity was noted due to variation in airway segmentation and measurement protocols. Mandibular advancement surgery is an effective and stable intervention for increasing pharyngeal airway dimensions, particularly in the oropharynx, among patients with mandibular retrognathism. These findings support the incorporation of airway assessment into orthognathic treatment planning and highlight the functional benefits of mandibular advancement beyond dentofacial correction.</p>

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Pharyngeal Airway Space Dimensional Change Following Isolated Mandibular Advancement Surgery: A Systematic Review and Meta-Analysis of 3 Dimensional Imaging Studies

  • 期刊论文

  • 发表日期：

    2026年3月31日

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  • Nidhi Khangar,
  • Samir Joshi,
  • Rajesh Kshirsagar,
  • Sudhir Pawar,
  • Vaishali Koranne

摘要

Mandibular retrognathism in skeletal Class II malocclusion is frequently associated with narrowing of the pharyngeal airway space (PAS), predisposing patients to compromised respiratory function and obstructive sleep apnoea (OSA). Mandibular advancement surgery has been proposed to improve airway dimensions; however, existing clinical evidence remains fragmented and largely descriptive. To quantitatively evaluate the effectiveness of mandibular advancement surgery on pharyngeal airway dimensions through a systematic review and meta-analysis of three-dimensional imaging-based evidence. The review was conducted in accordance with the PRISMA guidelines and registered in PROSPERO. Electronic searches were performed in PubMed, Scopus, Web of Science, and Google Scholar from January 2000 to September 2025. Eligible studies included prospective, retrospective, and controlled clinical studies assessing the impact of isolated mandibular advancement on airway volume and cross-sectional dimensions using computed tomography (CT) or cone-beam computed tomography (CBCT). Primary outcomes included total airway volume, segmental volumes of the nasopharynx, oropharynx, and hypopharynx, and minimum cross-sectional area (mCSA). Study quality and risk of bias were assessed using standardized tools. The systematic review included clinical studies involving adult skeletal Class II patients undergoing isolated mandibular advancement surgery. Meta-analysis revealed a statistically significant increase in total pharyngeal airway volume postoperatively, with the most pronounced expansion observed in the oropharyngeal region. The mCSA also showed significant improvement, indicating reduced airway collapsibility. Available longitudinal studies demonstrated maintenance of airway gains at one-year follow-up with minimal relapse. Considerable heterogeneity was noted due to variation in airway segmentation and measurement protocols. Mandibular advancement surgery is an effective and stable intervention for increasing pharyngeal airway dimensions, particularly in the oropharynx, among patients with mandibular retrognathism. These findings support the incorporation of airway assessment into orthognathic treatment planning and highlight the functional benefits of mandibular advancement beyond dentofacial correction.