P267 Swallowing and brainstem reflexes before and after mandibular sagittal split osteotomy

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Objectives

To study the electrophysiological parameters of swallowing and related brainstem reflexes before and after bilateral mandibular sagittal split osteotomy in patients with mandibular dentoskeletal deformities.

Methods

The patients were divided into 3 groups based on the occlusion pattern, Group I (Angle Class III malocclusion, 7 patients), Group II (Angle Class II malocclusion, 4 patients) and Controls (Class I occlusion, 12 healthy subjects). Swallowing reflex with 3–20 ml water bolus, blink reflexes (BR) with supraorbital and mental nerve stimulation, and masseter inhibitory reflex (MIR) during maximal intercuspidation were studied. Electrophysiological tests were repeated postoperatively in 2nd and 7th months.

Results

Oral preparation and triggering the pharyngeal phase of swallowing was shorter in Group II (especially with 15–20 ml water) and longer in Group I, as compared to the controls. Oral period shortened after surgery in Group I. In Group II, 2 patients had piecemeal deglutition during swallowing of 10–20 ml water, and one of them became normal after surgery. At the postoperative 2nd month examination, BR with mental nerve stimulation was suppressed bilaterally (with a unilaterally absent MIR) in one patient in Group I and unilaterally in one patient in Group II, with subsequent recovery.

Discussion and conclusion

Oral phase of swallowing is shorter in Group II, possibly due to the low volume capacity of the oral cavity. BR and MIR abnormalities substantiates the reversible inferior alveolar nerve damage.

Significance

This study combines the electrophysiological swallowing tests and brainstem reflexes in patients with mandibular malocclusion both before and after surgery.

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