Relationship between transoral atlantoaxial reduction
screw-rod system fixation and oropharyngeal airway stenosis

doi:10.3969/j.issn.2095-4344.2408

Abstract

Abstract:

BACKGROUND: In patients undergoing transoral atlantoaxial reduction and internal fixation, anterior atlantoaxial plate placement, soft tissue swelling and other factors may affect oropharyngeal space. Up to now, no anatomical factors regarding dysphagia or dyspnea after anterior approach for atlantoaxial dislocation have been reported.

OBJECTIVE: To observe the spatial changes of oropharyngeal airway after atlantoaxial dislocation and internal fixation with transoral atlantoaxial reduction screw-rod system and analyze the related influencing factors.

METHODS: Sixty-six patients with atlantoaxial dislocation undergoing transoral atlantoaxial reduction screw-rod system surgery were retrospectively included from January 2012 to December 2016 in the General Hospital of Southern Theater Command. There were 38 males and 28 females aged from 11 to 71 years. All patients signed the informed consent. This study was approved by the Hospital Ethics Committee. The narrowest oropharyngeal airway space, thickness of soft tissue before C₂ vertebra, anterior atlantodental interval, O-C₂ angle, and C₂-C₆angle were measured in the neutral position before and after surgery. Changes of postoperative data and their effects on the narrowest airway distance in oropharynx were analyzed.

RESULTS AND CONCLUSION: (1) The narrowest airway distance in oropharynx, anterior atlantodental interval and C₂-C₆ angle were significantly decreased after surgery compared with that before surgery (P < 0.001). Thickness of soft tissue before C₂ vertebra and O-C₂ angle increased significantly after surgery compared with that before surgery (P < 0.001). (2) In the multiple regression analysis, the change in the anterior atlantodental interval (β=7.070) and thickness of soft tissue before C₂ vertebra (β=0.387) were significant variables related to the change in the narrowest airway distance in oropharynx. On the contrary, there was no significant correlation with the O-C₂ angle. (3) It is indicated that reduction of atlantoaxial dislocation and the thickness of soft tissue before C₂ vertebrae have negative effect on the oropharyngeal airway space. Therefore, reduction of atlantoaxial dislocation during transoral reduction screw-rod surgery may cause postoperative dysphagia despite maintenance of the O-C₂ angle.

Key words: atlantoaxial dislocation, transoral atlantoaxial reduction and internal fixation, oropharyngeal airway space, O-C₂ angle, dysphagia, dyspnea

CLC Number:

R459.9

R318

R687

Yi Honglei, Chen Xingjie, Chen Xuqiong, Wu Zenghui, Ma Xiangyang, Ai Fuzhi, Wang Jianhua, Zhang Kai, Xia Hong. Relationship between transoral atlantoaxial reduction screw-rod system fixation and oropharyngeal airway stenosis[J]. Chinese Journal of Tissue Engineering Research, 2020, 24(3): 354-358.

Figures/Tables 5

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