Morphological changes in the upper airway after mandibular distraction osteogenesis and orthognathic surgery in paediatric and adult patients with hemifacial microsomia: a 3D retrospective study.

This retrospective study investigated morphological changes in the upper airway in 40 unilateral hemifacial microsomia patients following surgery. Sixteen paediatric patients underwent mandibular distraction osteogenesis (MDO), and 24 adult patients underwent MDO and/or orthognathic surgery. Pre- and postoperative computed tomography scans were acquired. Three-dimensional airway models of pediatric and adult cohorts were separately analyzed to assess volume, cross-sectional area, surface area, asymmetry and shape. In children, total mean ± standard deviation (SD) airway volume increased significantly from 9427.31 ± 4648.74 to 12,476.12 ± 5994.49 mm³ (P = 0.003), and mean ± SD cross-sectional area increased from 138.69 ± 59.89 to 178.39 ± 74.06 mm² (P = 0.006) after surgery. Surface area and minimum cross-sectional area also improved significantly. Asymmetry indices in the glossopharynx and hypopharynx decreased postoperatively. In adults, mean airway volume increased from 16,592.01 ± 3303.73 to 22,166.72 ± 4447.17 mm³ (P < 0.001), with significant gains in all pharyngeal regions except the nasopharynx. Improvements were also seen in surface area, symmetry and airway sphericity. These findings indicate that MDO and orthognathic surgery can improve the structure of the upper airway significantly in hemifacial microsomia patients. Incorporating airway analysis into surgical planning may enhance treatment outcomes for affected individuals.