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Prospective Analysis of the Swallowing Reflex After Sagittal Split Osteotomy: Comparison with Normal Volunteers

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Abstract

The aim of this study was electromyographic description of changes in swallowing before and after bilateral sagittal split ramus osteotomy. In this prospective study, twenty-eight patients were divided into 3 groups according to the occlusion pattern: Group I (Angle Class III), Group II (Angle Class II), and Control (Class I). Serial cone-beam computed tomography analyses and electromyographic data were collected preoperatively, 1st and 6th months after setback surgery in Group I, and advancement surgery in Group II. Swallowing reflex with 3–20 ml water bolus were studied. Patients were further divided into two subgroups according to the magnitude of relapse. The mean setback of the mandible was 4.62 ± 1.92 mm in Group I, and the mean advancement was 4.19 ± 2.00 mm in Group II. Mandibular relapse rate was 17.40%. Oral preparation phase shortened after surgery in both study groups. Two subjects in Group II and one in Group I had piecemeal deglutition, and two of them became normal postoperatively. Most of the swallowing durations of the relapsed cases were longer than those of stabilized patients. Important clinical considerations are as follows: the oral preparation period becomes shorter after surgery; piecemeal deglutition may disappear after treatment; and individuals with a longer oral period and piecemeal deglutition may have increased tendency to skeletal relapse. This multidisciplinary study enhances our understanding of the adaptive response to the swallowing reflex after orthognathic surgery and provides novel insight into the association between the submental muscle activity and relapse in orthognathic patients.

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Acknowledgements

The authors thank to Professor İbrahim Aydoğdu for kindly providing the piezoelectric sensor, Professor Zeynep Ahü Acar and Assistant Professor Kadir Beycan for radiological analysis, Dr. Leyla Baysal Kıraç for electromyographic analysis, Mevlüt Uzun for statistical assistance and, the subjects whose participation made this study possible.

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No funding was received.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey

    Aysenur Genc, Sabri Cemil Isler & Cengizhan Keskin

  2. Department of Neurology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey

    Ali Emre Oge

  3. Department of Neurology, Faculty of Medicine, Istanbul Bilim University, Istanbul, Turkey

    Zeliha Matur

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  1. Aysenur Genc
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  2. Sabri Cemil Isler
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  3. Cengizhan Keskin
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  4. Ali Emre Oge
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  5. Zeliha Matur
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Correspondence to Aysenur Genc.

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The authors declare that they have no conflict of interest.

Ethical Approval

The study conforms to the provisions of the Declaration of Helsinki (as revised in Tokyo 2004) and had been approved by the Institutional Review Board for Human Studies of the Dentistry Faculty of the Istanbul University, Turkey (Study 2015/69).

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Written informed consent was obtained from each participant.

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Genc, A., Isler, S.C., Keskin, C. et al. Prospective Analysis of the Swallowing Reflex After Sagittal Split Osteotomy: Comparison with Normal Volunteers. Dysphagia 35, 798–805 (2020). https://doi.org/10.1007/s00455-019-10085-y

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  • DOI: https://doi.org/10.1007/s00455-019-10085-y

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