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Changes in the upper airway after surgical correction of Class III skeletal
dentofacial deformity were investigated by measurement of the
cephalometric radiographs of 70 Class III subjects before surgery and 6
months after surgery. Comparison of the results with those of a normal
group of 74 subjects without deformity or surgery was also carried
out. Gender dimorphism in measurements and type of surgery performed
were taken into account. Results showed that postoperatively
the soft palate and hyoid bone were posteriorly displaced. In men, the
oropharyngeal, hypopharyngeal, and minimal airway depth were reduced,
but in women, the minimal depth was not reduced. In the
mandibular setback group, men showed posterior movement of the
tongue base, with decrease in minimal airway depth. In the maxillary
advancement group, nasopharyngeal depth increased in both genders.
In the bimaxillary surgery group, the soft palate moved posteriorly
and the tongue occupied a larger proportion of the airway in both
genders. The hyoid was displaced backwards in women, while men
showed a decrease in both oropharyngeal and minimal airway depth.
In comparison with normal subjects, postoperative measurements indicated
that the soft palate was reduced in length, thickness, and area,
and the base of the tongue was more posterior. Minimal pharyngeal
depth was reduced in both genders. After mandibular setback, the
tongue base was more posterior and the hypopharyngeal depth was
reduced. The bimaxillary surgery group also demonstrated a more
posterior tongue base but without reduction of the hypopharyngeal
depth. The mandibular setback group should be most at risk of obstructive
sleep apnea, but compensatory changes in soft palate morphology
may explain the low occurrence in practice.
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