The effect of mandibular advancement for mandibular deficiency dentofacial deformities on laryngeal grade and intubation difficulty: a preliminary study

Objective: The purpose of this study was to evaluate mandibular advancement for cases of mandibular deficiency with changes in vocal cord grade and intubation difficulty at subsequent surgery requiring intubation. Study Design: This retrospective case series included patients with a diagnosis of mandibular deficiency (Class II skeletal dentofacial deformity) who underwent mandibular advancement surgery (T1) followed by a subsequent surgery (T2) which required intubation. The primary predictor variable was mandibular advancement. The primary outcome variable was the change in laryngeal grade—Cormack and Lehane—after mandibular advancement. A secondary outcome was intubation difficulty after mandibular advancement. Results: Eight patients were included in the study. At T1, the average laryngeal grade was 1.6. There was 1 difficult intubation. The average time to T2 was 9 months. At T2, all patients were intubated on their first attempt, and all had a Cormack-Lehane Grade I view of the vocal cords. There were no difficult intubations at T2. Analysis showed a significant association between mandibular advancement and laryngeal grade at T2 (P =.03; 95% CI 0.07-1.13). Conclusions: This preliminary investigation found an association between mandibular advancement for cases of mandibular and improved laryngeal grade at subsequent intubation without any difficult intubations.