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Objective: To retrospectively evaluate the effects of single mandibular advancement (MA) and two-jaw surgery (2J-S) on the pharyngeal airway space (PAS) and hyoid position for the correction of skeletal Class II malocclusion. Methods: Eleven adult patients who underwent only MA surgery and twelve adult patients who underwent Le Fort I maxillary impaction-MA surgery (2-JS) were included in the retrospective study. A total of 46 cephalometric recordings obtained before (T1) and after treatment (T2) were examined. Craniofacial changes, area, and linear measurements of the pharyngeal airway and hyoid bone position were obtained in both groups. The Wilcoxon signed-rank test was used to evaluate time-dependent changes within groups. The Mann-Whitney U test was used to compare differences between groups. Results: Hyoid-Vert values increased significantly in both groups (MA, p<0.01; 2J-S, p<0.05); however, Hyoid-Hor values decreased significantly only in the 2J-S group (p<0.01). The anteroposterior dimensions of the airway increased in both groups, except for the PNS-P and PPS groups (p<0.01). Although a significant increase was observed in the nasopharyngeal area (A1) in the MA group (p<0.05), the decrease was found to be statistically significant in 2JG (p<0.01). Significant increases were found in the oropharyngeal (A2) and hypopharyngeal areas (A3) in both groups (p<0.01, p<0.05). Conclusion: Both surgical procedures for the correction of Class II malocclusion resulted in increased hypopharyngeal, oropharyngeal, and total airway measurements. [ABSTRACT FROM AUTHOR]

Objective: To retrospectively evaluate the effects of single mandibular advancement (MA) and two-jaw surgery (2J-S) on the pharyngeal airway space (PAS) and hyoid position for the correction of skeletal Class II malocclusion. Methods: Eleven adult patients who underwent only MA surgery and twelve adult patients who underwent Le Fort I maxillary impaction-MA surgery (2-JS) were included in the retrospective study. A total of 46 cephalometric recordings obtained before (T1) and after treatment (T2) were examined. Craniofacial changes, area, and linear measurements of the pharyngeal airway and hyoid bone position were obtained in both groups. The Wilcoxon signed-rank test was used to evaluate time-dependent changes within groups. The Mann-Whitney U test was used to compare differences between groups. Results: Hyoid-Vert values increased significantly in both groups (MA, p

To outline the effect of a Le Fort 1-type advancement osteotomy or Le Fort 1 level distraction osteogenesis (DO) procedure with anterior repositioning on speech, respiration and dimensions of the pharyngeal airway in patients with cleft lip and/or palate. This systematic review was conducted by following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). For studies published until October 2023, an electronic search was conducted, and those were included in which the impact of Le Fort 1 maxillary advancement (I) on the speech, breathing, and pharyngeal airway dimensions (O) compared to pre-operative situation (C) in the patients with non -syndromic cleft lip/palate (P) were assessed. A meta-analysis was done to assess the difference in the amount of pharyngeal depth. From 892 studies, 19 studies were included in the analysis. All studies reported an increase of airway dimensions that were evaluated with 3D-imaging, velar length and improvement in breathing after the intervention. Meta-analysis of the six studies revealed the significant increase of the following variables: nasopharyngeal depth (NPD) immediately after the Le Fort 1 osteotomy, NPD and middle pharyngeal depth immediately and 12 months after Le Fort 1 DO. In patients with cleft lip and/or palate, maxillary advancement using Le Fort 1 osteotomy and Le Fort 1 DO can significantly increase the dimensions of the airway in the nasopharynx. However, the changes in speech and breathing parameters were not significant in the scrutinized literature. Impact of Le Fort maxillary advancement on patients' speech remains controversial. [ABSTRACT FROM AUTHOR]

Objective To investigate the morphological changes in the upper airway after bimaxillary surgery in patients with skeletal Class Ⅲ malocclusion and the relationship between jaw movement and airway changes using CBCT. Methods This study involved 44 individuals(21 males and 23 females)receiving Class Ⅲ bimaxillary surgery. Preoperative and 3-6-month postoperative CBCT data were examined using Dophin3D 11.95 software. The alterations before and after upper airway surgery were analysed using paired t-test and non-parametric Wilcoxon rank sum test. The association between airway alterations and jaw movement was examined using Pearson’s correlation coefficient. Results Patients who underwent Class Ⅲ bimaxillary surgery had significantly reduced upper airway volume, sagittal cross-sectional area, and minimum cross-sectional area(P7 mm, the decrease in upper airway volume increased significantly(P7 mm)may reduce postoperative upper airway capacity and increase the risk of OSAHS. Patients at risk of upper airway stenosis should have their protocol modified to reduce airway risk.

Background. The patency of the pharyngeal airway has a far-reaching impact on craniofacial development. Conversely, the position of the maxillofacial skeletal components in certain disorders may lead to a compromised airway. Therefore, the evaluation of the airway is an essential step in treatment planning. Objectives. The basic aim of this study was to measure the pharyngeal air space volume in the patients with maxillofacial skeletal abnormalities (like Class II, Class III malocclusion, TMJ Ankylosis, Condylar abnormalities and Syndromic cases) and those without any skeletal abnormalities. The objectives were to assess the Linear, Cross-sectional, and Volumetric dimensions of the pharyngeal airway in patients with and without maxillofacial skeletal abnormalities. (Study and Control group) Materials and methods. The Study group included 49 patients with maxillofacial Skeletal abnormalities like Class II and Class III malocclusion, Temporomandibular Joint Ankylosis, Condylar abnormalities, Syndromic cases. 49 Control group patients did not present with any skeletal abnormalities. The Linear, Cross-sectional, and Volumetric dimensions of the pharyngeal airway in the Study group and Control group were calculated and compared within the groups. Statistical Analysis: Unpaired t -test, ANOVA test and Tukey’s Post Hoc analysis test were for the data analysis of the above study. Outcomes. The Anteroposterior dimension of the airway at the Superiormost level was found to be significantly greater in Class II (p-value-0.039), Class III (p-value-0.002), and Control groups (p-value

Background. The patency of the pharyngeal airway has a far-reaching impact on craniofacial development. Conversely, the position of the maxillofacial skeletal components in certain disorders may lead to a compromised airway. Therefore, the evaluation of the airway is an essential step in treatment planning. Objectives. The basic aim of this study was to measure the pharyngeal air space volume in the patients with maxillofacial skeletal abnormalities (like Class II, Class III malocclusion, TMJ Ankylosis, Condylar abnormalities and Syndromic cases) and those without any skeletal abnormalities. The objectives were to assess the Linear, Cross-sectional, and Volumetric dimensions of the pharyngeal airway in patients with and without maxillofacial skeletal abnormalities. (Study and Control group) Materials and methods. The Study group included 49 patients with maxillofacial Skeletal abnormalities like Class II and Class III malocclusion, Temporomandibular Joint Ankylosis, Condylar abnormalities, Syndromic cases. 49 Control group patients did not present with any skeletal abnormalities. The Linear, Cross-sectional, and Volumetric dimensions of the pharyngeal airway in the Study group and Control group were calculated and compared within the groups. Statistical Analysis: Unpaired t -test, ANOVA test and Tukey's Post Hoc analysis test were for the data analysis of the above study. Outcomes. The Anteroposterior dimension of the airway at the Superiormost level was found to be significantly greater in Class II (p-value-0.039), Class III (p-value-0.002), and Control groups (p-value <0.001) when compared with the TMJ Ankylosis group. The Volume and Cross-sectional area of the airway at the most constricted level of the airway was found to be significantly greater in Class III (p-value <0.001) and Control group (p-value 0.013, 0.003) respectively when compared with the TMJ Ankylosis group. Conclusions. The pharyngeal airway was narrowest anteroposteriorly at all three levels (Superior-most, Most constricted, and Inferior-most levels) in the TMJ Ankylosis group and widest in the Class III group. The least cross-sectional area was found in the TMJ Ankylosis group whereas the greatest was found in the Class III group. The airway volume in the TMJ Ankylosis group and Class II group is significantly lesser than that of the Control group. [ABSTRACT FROM AUTHOR]

Background: This study is a pioneer systematic review and meta-analysis aimed at comparing the influence of Class II and Class III skeletal malocclusions on pharyngeal airway dimensions. It stands as the inaugural comprehensive assessment to collate and analyze the disparate findings from previously published articles on this topic. The objective of this study was to identify published articles that compare the effects of class II and class III skeletal malocclusion on the pharyngeal airway dimensions. Methods: An all-inclusive search for existing published studies was done to identify peer-reviewed scholarly articles that compared the influence of class II and class III skeletal malocclusion on pharyngeal airway dimensions. The search was done via five electronic databases: Cochrane Library, EMBASE, Scopus, Web of Science, and PubMed. Screening of the articles was done and the eligible studies were critically assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Results: The initial search yielded 476 potential articles of which, nine were finally included in this study for a total of 866 patients. Three studies were of cross-sectional design and six were of retrospective study design. Following a critical analysis and review of the studies, class III skeletal malocclusion had significantly larger volume and area measurements compared to class II skeletal malocclusion. Conclusion: Research in the field of literature has established that variations in skeletal classifications have a discernible effect on the size of the pharyngeal airways. With the advancement of skeletal malocclusions to a class III, there is an observed increase in both the volume and cross-sectional area of the airways.

Objectives: We aimed to explore the position, morphological, and morphometric properties of the hyoid bone (HB) and to investigate the effect of HB on the pharyngeal airway (PA) volume and cephalometric measurements. Methods: A total of 305 patients with CT images were included in the study. DICOM images were transferred to the InVivoDental three-dimensional imaging software. The position of the HB was determined based on the cervical vertebra level and in volume render tab, the bone was classified into six types after all structures around the HB were removed. Also, final bone volume was recorded. In the same tab, the pharyngeal airway volume was divided and measured in three groups (nasopharynx–oropharynx–hypopharynx). The linear and angular measurements were performed on the 3D cephalometric analysis tab. Results: HB was most commonly located in C3 vertebra level (80.3%). While B-type was found to be the most frequent (34%), V-type was the least frequent (8%). The volume of the HB was found to be significantly higher in male (3205 mm3) than female (2606 mm3) patients. Also, it was significantly higher in the C4 vertebra group. The vertical height of the face was positively correlated with the HB volume, C4 level position, and increased oro-nasopharyngeal airway volume. Conclusion: The volume of the HB is found to differ significantly between genders and can potentially serve as a valuable diagnostic tool for understanding respiratory disorders. Its morphometric features are associated with increased face height and airway volume; however, are not related with the skeletal malocclusion classes. [ABSTRACT FROM AUTHOR]

Objective: Functional appliances are used in orthodontics to bring about correction of mandibular retrognathism by forward positioning and eventually remodeling the condyle- glenoid fossa to retain this new position. Research has shown that these appliances have a significant effect on pharyngeal airway of patients. The aim of this study was to evaluate changes in volume and minimum constriction area in the pharyngeal airway using CBCT imaging after correction of mandibular retrognathism with an Advansync2 Class II corrector. Methods: This single-center study consisted of 20 Class II patients (mean age 14.8 years) who required correction of mandibular retrognathism. The patients were treated with the Advansync2 Class II corrector for an average of 26 weeks. CBCT records were taken at T0 (beginning of treatment) and T1 (end of functional phase). The airway was segmented into lower nasopharynx, velopharynx and oropharynx and analyzed for changes in partial volume, total volume, and minimum area using a CBCT software [NewTom 3GTM (Newtom- Cefla S.C., Verona, Italy)]. Results: The partial and total volumes were significantly larger at T1 than at T0 (p =.003,.001). In addition, minimum area also improved in each part of the airway (p =.005,.022,.001). Conclusion: The Advansync2 fixed functional appliance can be used in Class II patients requiring improvement in their airway dimensions. However, additional long-term studies are recommended to confirm these findings. [ABSTRACT FROM AUTHOR]

Amaç: Bu araştırmada, iskeletsel Sınıf 1 ilişkiye sahip bireylerde dik yön büyüme paterninin farengeal havayolu boyutlarına ve hyoid kemik pozisyonuna etkisinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Bu retrospektif araştırmaya, ANB açısı temel alınarak iskeletsel Sınıf 1 ilişkiye sahip toplam 72 birey (36 kadın, 36 erkek; ortalama yaş: 17.78 ± 1.39 yıl) dahil edildi. Bireyler dik yön büyüme paternine göre; normodiverjan, hipodiverjan ve hiperdiverjan olmak üzere 3 gruba ayrıldı. Lateral sefalometrik radyografiler üzerinde farengeal havayolu ve hyoid kemik pozisyonu ölçümleri, 1 açısal ve 10 lineer ölçüm kullanılarak yapıldı. Verilerin analizinde bağımsız örneklem t-testi ve tek yönlü varyans analizi (ANOVA) kullanılarak grup içi ve gruplar arası farklılıklar değerlendirildi (p

Background In growing patients with skeletal discrepancies, early diagnosis, evidence-based explanation of etiology, and assessment of functional factors can be vital for the restoration of normal craniofacial growth and the stability of treatment needs. Aims The aim of the study was to assess dentofacial characteristics as well as upper and lower pharyngeal airway in children with skeletal class II malocclusion with mouth breathing, and to investigate possible significant relationships and correlations among the studied cephalometric variables and the airway morphology in these children. Materials and Methods Sixty untreated children, aged 9 to 13 years, were divided into three groups according to clinical findings and cephalometric analysis of dentofacial characteristics as well as the presence of mouth breathing habit: Group I (20 children with normal jaw relation/class I), Group II (20 children with skeletal class II), and Group III (20 children with skeletal class II with confirmed mouth breathing habit). Cephalometric variables and upper/lower airway widths were recorded. Intergroup comparison of all measurements was performed by post hoc Tukey test, and Pearson's correlation was used to determine the correlation among the variables. Results Significant changes existed in more than half of the dentofacial measurements among the three groups. Significantly greater skeletal anteroposterior jaw discrepancy and mandibular retrognathism were found in both groups II and III as determined by specific anteroposterior determinants. Children in group III showed significantly increased angle between Sella-Nasion and mandibular plane (SN-MP) angle, y -axis, and a vertical growth pattern. Significant increases in dental measurements, namely upper incisor to Nasion- point A (NA), lower incisor to Nasion - point B (NB), and overjet, were found in group II and group III, while overbite showed a significant decrease. Upper pharyngeal airway width was found to be significantly decreased in group III followed by a smaller though significant decrease in group II. No significant differences were found in lower pharyngeal airway width between the groups. There were statistically significant dentofacial characteristics that showed fair to good correlation with the upper airway width. Conclusion Children with skeletal class II malocclusion with and without mouth breathing showed significant differences in dentofacial measurements and a significantly narrower upper pharyngeal airway as compared with children with normal jaw/class I relation. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to evaluate pharyngeal airway changes in adult skeletal Class III cases whose bimaxillary surgical treatments were planned with different amounts of maxillary and mandibular movement using lateral cephalometric radiographs and finite element analysis (FEA). Our null hypothesis was that bimaxillary orthognathic surgery in which maxillary forward movement (MF) is greater than mandibular backward movement (MB) will result in more expansion of the pharyngeal airway. Materials and Methods: A total of 31 individuals (11 females, 20 males) with class III skeletal deformity were included in the study. Patients who underwent bimaxillary orthognathic surgery with greater maxillary advancement (MF > MB) were categorized in Group 1 (n = 15), and those with greater mandibular set-back (MB > MF) as Group 2 (n = 16). Changes in airway dimensions were evaluated from lateral cephalometric radiographs. In addition, FEA modeling was used to determine pharyngeal airway changes with 5 different MF/MB combinations performed in skeletal class III bimaxillary surgeries. Results: Nasopharyngeal and oropharyngeal airway dimensions increased in direct proportion to the amount of MF. Hypopharyngeal volume decreased compared to preoperative value in direct proportion to the decrease in MB. According to the FEA models, total pharyngeal airway volume decreased when MF was less than or equal to MB, was nearly unchanged when MF was 2 mm greater than MB, and increased when MF was 4 mm greater than MB. The results of FEA and lateral cephalometric analysis were compatible. Conclusion: Our results supported the null hypothesis. We concluded that when possible, planning slightly more maxillary advancement than mandibular set-back will not have an adverse impact on the airway. Although the skeletal deformity only causes forward displacement of the mandible, dividing the skeletal correction between the maxilla and mandible may be considered to avoid the risk to patients' quality of life in terms of respiratory function. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the effects of a partial glossectomy on volumetric changes of pharyngeal airway space (PAS) in patients with mandibular setback surgery. Overall, 25 patients showing clinical features related to macroglossia treated with mandibular setback surgery were included in this retrospective study. Subjects were divided into two groups: the control group (G1, n = 13, with BSSRO) and the study group (G2, n = 12, with both BSSRO and partial glossectomy). The PAS volume of both groups was measured by the OnDemand 3D program on CBCT taken shortly before operation (T0), 3 months post-operative (T1), and 6 months post-operative (T2). A paired t-test and repeated analysis of variance (ANOVA) were used for statistical correlation. Total PAS and hypopharyngeal airway space were increased after operation in Group 2 compared to Group 1 (p < 0.05), while oropharyngeal airway space showed no significant statistical difference with the tendency of increasing. The combination of partial glossectomy and BSSRO surgical techniques had a significant effect on increasing the hypopharyngeal and total airway space in class III malocclusion patients (p < 0.05). [ABSTRACT FROM AUTHOR]

Abstract Objective This study was conducted to compare changes in pharyngeal airway after different orthognathic procedures in subjects with class III deformity. Methods The study included CBCT scans of 48 skeletal class III patients (29 females and 19 males, mean age 23.50 years) who underwent orthognathic surgery in conjunction with orthodontic treatment. The participants were divided into three groups of 16, as follows: Group 1, mandibular setback surgery; group 2, combined mandibular setback and maxillary advancement surgery; and group 3, maxillary advancement surgery. CBCT images were taken 1 day before surgery (T0), 1 day (T1), and 6 months (T2) later. The dimensions of the velopharynx, oropharynx, and hypopharynx were measured in CBCT images. Results In all groups, there was a significant decrease in airway variables immediately after surgery, with a significant reversal 6 months later (P

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Objective:The enhanced effect of maxillary protraction following the Alternate Rapid Maxillary Expansion-Constriction/Reverse Headgear (AltRAMEC/RH) protocol over the Rapid Maxillary Expansion/Reverse Headgear (RME/RH) protocol has been well documented. However, it is not known if the airway dimensions also follow a similar enhancement. This retrospective cohort study therefore aims to compare dimensional changes in the pharyngeal airway after maxillary protraction following RME/RH, versus AltRAMEC/RH.Methods: Pre- and post-treatment lateral cephalograms of 46 skeletal Class III patients with maxillary retrusion, who had undergone maxillary protraction using the AltRAMEC/RH or RME/RH protocol were compared for 20 dentoskeletal and airway variables. The waiting period of 6-8 months before initiating treatment served as the control period. The results were statistically evaluated using the paired t-test, the independent t-test, and the intraclass correlation coefficient.Results: The nasopharyngeal airway indicators in the AltRAMEC/RH group (PNS-ad1, PNS-ad2, UPD) showed a statistically significant mean increase of 2.09 mm, 2.74 mm, and 1.30 mm respectively. This was significantly more pronounced than the RME/RH group (P < .001). The control period did not show any significant change, thus showing the negligible effect of growth on the airway dimension. No significant changes were observed in the oropharyngeal airway indicators for both groups (P > .001).Conclusions: The AltRAMEC/RH protocol produced more significant improvement in the nasopharyngeal airway dimensions as compared to the RME/RH protocol. The changes in the oropharyngeal airway were insignificant with both the protocols.

Copyright of Acta Odontologica Turcica is the property of Acta Odontologica Turcica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The pharyngeal airway is a crucial part of the respiratory system's function. Assessing the pharyngeal airway dimensions in different skeletal types is important in the orthodontic treatment of growing patients. The aim of this study was to compare the upper pharyngeal airway dimensions of 7–14-year-old children with different skeletal types. Methods: Three-hundred-sixty-one lateral cephalometric radiographs were grouped based on their skeletal patterns determined by the ANB angle as skeletal type I (n = 123), type II (n = 121), and type III (n = 117). The radiographs were divided into 4 groups: 7/8 YO (7–8 years old), 9/10 YO, 11/12 YO, and 13/14 YO. The cephalometric measurements comprised SNA, SNB, ANB, Ad1-PNS, Ad2-PNS, McUP, and McLP. An ANOVA was used to compare the group results. Results: Significant differences in Ad1-PNS, Ad2-PNS, McUP, and McLP in skeletal types II and III were found between age groups. Most upper pharyngeal airway dimensions in skeletal types II and III children were significantly wider in the 13/14 YO group than in the other age groups. Conclusion: The upper pharyngeal airway dimensions increased age-dependently in 7–14-year-old children, especially in skeletal types II and III. The upper pharyngeal airway dimensions could serve as a guide in differentiating the different skeletal classes in clinical settings. [ABSTRACT FROM AUTHOR]

High activity of upper airway dilator muscles is thought to be critical in preventing sleep-related upper airway collapse. To date, most of the research regarding upper airway dilator muscles has focused on the genioglossus muscle, which protrudes the tongue and opens the retroglossal airway. However, collapse commonly occurs in the retropalatal region. We therefore aimed to examine the motor control of the palatoglossus muscle as well as investigate breathing route-related changes in genioglossus and palatoglossus motor units. Single motor unit recordings of the genioglossus and palatoglossus were made simultaneously in healthy individuals during wakefulness while breathing through the nose with the mouth closed (NMC), nose with mouth open (NMO) or orally (OMO). The palatoglossus was found to have all 5 motor unit firing patterns that have been observed in other upper airway dilator muscles, but during nasal breathing had a higher proportion of tonically active but inspiratory modulated motor units as compared to the genioglossus (67% vs 30%). When still breathing nasally but with the mouth open, the units with an expiratory firing pattern in genioglossus, and all firing patterns in palatoglossal, increased their firing rates compared to nasal breathing with the mouth closed (GG: 17.8±4.9 vs 23.1±4.8 Hz, PG: 17.0±4.0 vs 19.3±4.0 Hz). Finally, oral breathing resulted in dramatic reductions in the number of palatoglossal motor units that were firing (35 units vs 92 during nasal breathing). Palatoglossus activity may contribute importantly to airway collapsibility and may provide an alternate pathway for preventing sleep-related airway collapse.

Abstract Background This study evaluated the pharyngeal airway space changes up to 1 year after bilateral sagittal split osteotomy mandibular setback surgery and bimaxillary surgery with maxillary posterior impaction through three-dimensional computed tomography analysis. Methods A total of 37 patients diagnosed with skeletal class III malocclusion underwent bilateral sagittal split osteotomy setback surgery only (group 1, n = 23) or bimaxillary surgery with posterior impaction (group 2, n = 14). Cone-beam computed tomography scans were taken before surgery (T0), 2 months after surgery (T1), 6 months after surgery (T2), and 1 year after surgery (T3). The nasopharynx (Nph), oropharynx (Oph), hypopharynx (Hph) volume, and anteroposterior distance were measured through the InVivo Dental Application version 5. Results In group 1, Oph AP, Oph volume, Hph volume, and whole pharynx volume were significantly decreased after the surgery (T1) and maintained. In group 2, Oph volume and whole pharynx volume were decreased (T2) and relapsed at 1 year postoperatively (T3). Conclusion In class III malocclusion patients, mandibular setback surgery only showed a greater reduction in pharyngeal airway than bimaxillary surgery at 1 year postoperatively, and bimaxillary surgery was more stable in terms of airway. Therefore, it is important to evaluate the airway before surgery and include it in the surgical plan.

To compare pharyngeal airway dimensions and hyoid bone position in different craniofacial growth patterns. In total, 611 patients divided into 9 subgroups were compared according to malocclusion classification and vertical growth pattern, and these subgroups were compared in terms of pharyngeal airway and hyoid measurements. A two-way ANOVA test was used to compare the findings of the subgroups. No significant difference was found for the pharyngeal measurements between the groups (p>0.05). The vertical airway length (PNS-Ep) was significantly shorter in the Class III malocclusion group (p<0.05) and in the hypodivergent group (p<0.05). No statistically significant difference was found between any subgroups in any measurements of the position of the hyoid bone (p>0.05). The pharyngeal airway dimensions and hyoid bone position are similar among individuals in the sagittal direction. The vertical airway length is significantly shorter in Class III and hypodivergent individuals. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted to compare changes in pharyngeal airway after different orthognathic procedures in subjects with class III deformity. Methods: The study included CBCT scans of 48 skeletal class III patients (29 females and 19 males, mean age 23.50 years) who underwent orthognathic surgery in conjunction with orthodontic treatment. The participants were divided into three groups of 16, as follows: Group 1, mandibular setback surgery; group 2, combined mandibular setback and maxillary advancement surgery; and group 3, maxillary advancement surgery. CBCT images were taken 1 day before surgery (T0), 1 day (T1), and 6 months (T2) later. The dimensions of the velopharynx, oropharynx, and hypopharynx were measured in CBCT images. Results: In all groups, there was a significant decrease in airway variables immediately after surgery, with a significant reversal 6 months later (P < 0.05). In subjects who underwent maxillary advancement, the airway dimensions were significantly greater at T2 than the T0 time point (P < 0.05), whereas in the mandibular setback and bimaxillary surgery groups, the T2 values were lower than the baseline examination (P < 0.05). The alterations in airway variables were significantly different between the study groups (P < 0.05). Conclusions: The mandibular setback procedure caused the greatest reduction in the pharyngeal airway, followed by the bimaxillary surgery and maxillary advancement groups, with the latter exhibiting an actual increase in the pharyngeal airway dimensions. It is recommended to prefer a two-jaw operation instead of a mandibular setback alone for correction of the prognathic mandible in subjects with predisposing factors to the development of sleep-disordered breathing. [ABSTRACT FROM AUTHOR]

Background/purpose: Proper breathing is essential to healthy growth and development of children. The present study aimed to investigate changes in the pharyngeal airway space in primary-school children. Materials and methods: Cephalometric radiographs were obtained from 93 primary-school children, who were divided into three age groups (Group I, aged 7–8 years; Group II, aged 9–10 years; and Group III, aged 11–12 years). Landmarks identified on each cephalogram included the tip of the uvula (U), hyoid bone (H), and epiglottis (E). Linear and angular measurements comprised nasopharyngeal airway (NP); PS (shortest distance from the soft palate to the pharyngeal wall); UP (distance from the tip of the uvula to the pharyngeal wall); TS (shortest distance from the posterior tongue to the pharyngeal wall); EP (distance, parallel to the X-axis, from the epiglottis to the pharyngeal wall). Statistical analysis was performed using one-way analysis of variance and Pearson correlation tests. Results: Group III had the highest values for all the variables. The three groups exhibited significant differences for all pharyngeal airway variables, except for EP. The three groups had significantly different vertical U, H, and E. There were positive correlations between age and NP, PS, UP, and TS; however, no significant correlation was observed between age and EP. Age significantly correlated with the vertical U, E, and H. Correlations between age and the horizontal U, E, and H were nonsignificant. Conclusion: Among primary-school children from various grades, age significantly correlated with all pharyngeal airway variables, except with EP.

Objective: To assess the relationship of pharyngeal airway dimensions and the position of the hyoid bone in several craniofacial morphologies among Nepali adults. To assess the relationship between dimensions of the pharyngeal airway and position of the hyoid bone and compare gender dimorphism. Materials and Methods: The cross-sectional observational research comprised lateral cephalograms of 150 subjects aged 16 to 30 years. Samples were separated into three sagittal craniofacial morphological groups based on the ANB (A point, nasion, B point) angle and into gender groups. Different parameters (linear and angular) for measuring dimensions of the pharyngeal airway and position of the hyoid bone were assessed. An ANOVA test and a Pearson correlation test were performed. Results: Dimensions of the pharyngeal airway were largest in skeletal Class III when compared to skeletal Class I and Class II subjects, with a lower pharyngeal airway space and the length of the nasal fossa being significantly larger. The hyoid bone was anteriorly and inferiorly placed in Class III skeletal subjects. Males had greater pharyngeal airway dimensions and a hyoid bone positioned more inferiorly and anteriorly. The nasal fossa length had a strong positive correlation with the hyoid bone position vertically. Conclusion: There were differences in the dimensions of the pharyngeal airway and position of the hyoid bone in various craniofacial morphologies among Nepali adults. Gender dimorphism was observed in both dimensions of the pharyngeal airway and the position of the hyoid bone. [ABSTRACT FROM AUTHOR]

Objective: To investigate volumetric and circumferential pharyngeal airway space (PAS) changes and stability over time as evaluated with cone beam computed tomography (CBCT) before and after orthognathic surgery 2 years postoperatively. Materials and methods: One hundred twenty-eight patients underwent bimaxillary orthognathic surgery at the Department of Maxillofacial Surgery of University Hospitals, Leuven, Belgium, were recruited prospectively. Patients were divided into 4 groups based on the amount of mandibular advancement in 5 mm increments (< 0 mm, 0–5 mm, 5–10 mm, or > 10 mm). CBCT data was acquired preoperatively and 1–6 weeks, 6 months, 1 year, and 2 years postoperatively. Patients with a history of maxillofacial trauma or surgery, obstructive sleep apnoea syndrome, or craniofacial anomalies were excluded. Nasopharyngeal, oropharyngeal, and hypopharyngeal PAS volumes and constriction surface areas (mCSA) were measured and compared between each time point with a paired t-test. Results: The largest significant increase in oropharyngeal volume and mCSA were observed in the 5–10 mm (+ 13.3–21.7%, + 51.3–83.0%)) and > 10 mm (+ 23.3–44.6%, + 92.3–130.0%) mandibular advancement groups. This increase only remained stable 2 years postoperatively in the > 10 mm group. In other mandibular advancement groups, short-term oropharyngeal volume and mCSA increases were noticed, which returned to baseline levels 6 months to 1 year postoperatively. Conclusion: Bimaxillary advancement osteotomy significantly increases oropharyngeal volume and mCSA, which remains stable between 6 months to 1 year postoperatively. Clinical relevance: Long-term stable volumetric and mCSA enlargements were found with > 10 mm mandibular advancements over a period of 2 years. Return towards baseline levels was observed in the other mandibular advancement groups. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Orthodontic treatment modalities depend on individual patient's growth pattern and mandibular position. The airway is an important determinant of treatment. Therefore, a clear correlation between different growth patterns, mandibular positions, and airway would lead to better diagnosis and more specific planning. OBJECTIVES: The aim of this study was to evaluate mandibular position and its' relationship to pharyngeal airway dimensions in patients with different growth patterns using cone-beam computed tomography (CBCT). MATERIAL AND METHODS: CBCT scans of patients were assigned to vertical, average, and horizontal growth pattern types, based on angular (S-N/Go-Me) and linear (S-Go/N-Me) measurements. Data of included patients was used for 3-dimensional reconstruction of the pharyngeal airway to assess parameters, such as total airway volume, airway length, mandibular position, and correlation with different growth patterns. For statistical analysis, one-way ANOVA, post-hoc Tukey test (for pairwise comparisons), and Spearman's correlation with a significance level of 0.05 were applied. RESULTS: The mandibular distance from the airway was significantly higher in the horizontal growth pattern group (p = 0.035). Airway volume was lower in the vertical growth pattern group as compared with the horizontal growth pattern group (p = 0.043). A negative correlation was observed between mandibular position and airway length (p = 0.021, r = -0.338). CONCLUSIONS: Subjects with horizontal growth patterns tend to have shorter and wider airways with their mandibles farther away, as compared to those with vertical growth patterns. To avoid the risk of compromising narrow airway dimensions, clinicians must take into account these findings while planning orthodontic and surgical treatment. [ABSTRACT FROM AUTHOR]

Objective: The enhanced effect of maxillary protraction following the Alternate Rapid Maxillary Expansion-Constriction/Reverse Headgear (AltRAMEC/RH) protocol over the Rapid Maxillary Expansion/Reverse Headgear (RME/RH) protocol has been well documented. However, it is not known if the airway dimensions also follow a similar enhancement. This retrospective cohort study therefore aims to compare dimensional changes in the pharyngeal airway after maxillary protraction following RME/RH, versus AltRAMEC/RH. Methods: Pre- and post-treatment lateral cephalograms of 46 skeletal Class III patients with maxillary retrusion, who had undergone maxillary protraction using the AltRAMEC/RH or RME/RH protocol were compared for 20 dentoskeletal and airway variables. The waiting period of 6-8 months before initiating treatment served as the control period. The results were statistically evaluated using the paired t-test, the independent t-test, and the intraclass correlation coefficient. Results: The nasopharyngeal airway indicators in the AltRAMEC/RH group (PNS-ad1, PNS-ad2, UPD) showed a statistically significant mean increase of 2.09 mm, 2.74 mm, and 1.30 mm respectively. This was significantly more pronounced than the RME/RH group (P < .001). The control period did not show any significant change, thus showing the negligible effect of growth on the airway dimension. No significant changes were observed in the oropharyngeal airway indicators for both groups (P > .001). Conclusions: The AltRAMEC/RH protocol produced more significant improvement in the nasopharyngeal airway dimensions as compared to the RME/RH protocol. The changes in the oropharyngeal airway were insignificant with both the protocols. [ABSTRACT FROM AUTHOR]

Objectives: To test the hypothesis that there is no positive correlation between skeletal Class II and mandibular morphology with pharyngeal dimensions in subjects with different growth patterns. Materials and Methods: Lateral cephalograms of 60 patients were collected and divided into 2 groups, comprising of 30 in each group. Group 1 consisted of cephalograms of patients having Class I malocclusion, and was further divided into subgroups. 1a) Class I with normal growth 1b) Class I with vertical growth. Group 2 consisted of cephalograms of patients having class II malocclusion and was further divided into subgroups 2a) Class II with normal growth, 2b) Class II with vertical growth. Results: The results showed that the estimated marginal mean for upper pharyngeal width in class I malocclusion group was 8.56 mm, for class II malocclusion group was 7.80 mm, for normal growth individuals was 9.73 mm and that for vertical growth individuals was 6.63 mm. The estimated marginal mean for lower pharyngeal width in class I malocclusion group was 9.62 mm, in class II malocclusion group was 9.10 mm, in normal growth individuals was 8.95 mm and that in vertical growth individuals was 9.77 mm. The estimated marginal mean for pharyngeal area in class I malocclusion group is 330.13 sq.mm, in class II malocclusion group is 308.17 sq.mm, in normal growth individuals is 328.47sq.mm and that in vertical growth individuals is 309.83 sq.mm. Conclusions: The null hypothesis for this study, as per the statistical analysis, has been rejected.

Introduction: Oral submucous fibrosis (OSMF) alters the pharynx, which may affect airway size. MRI will be useful for diagnosing pharyngeal abnormalities. MRI is used to evaluate pharyngeal airway and soft palate changes in OSMF patients., Materials and Methods: This study is a cross-sectional observational study that included a sample size of 42 patients. Group A consisted of 21 patients with OSMF, while Group B consisted of 21 volunteers without OSMF, who served as the control group. The patients with OSMF were classified into Stages I, II, and III according to the categorization established by Pindborg JJ in 1989, Stop-Bang questionnaire was employed to assess obstructive sleep apnoea. Magnetic Resonance Imaging (MRI) was utilized to acquire evaluations of the pharyngeal airway, encompassing measurements in the midsagittal, cross-sectional width, length planes, and cross-sectional area with volume, for all participants. The Shapiro-Wilk test determines distribution normality. We utilized one-way ANOVA to compare the means between groups., Results: The average age of OSMF patients was 45.9 ± 8.16, while the control group was 39.19 ± 4.21. Stage I of OSMF had the highest mean Stop Bang questionnaire score (2.75), followed by stage III (2.22), and stage II (1.75). Statistically significant differences (p < 0.001) were seen in volume, linear midsagittal planes, cross-sectional width and length planes, cross-sectional area, and soft palate breadth and length between OSMF and control groups., Conclusion: MRI can effectively examine early changes in the pharyngeal airway of patients with OSMF thereby serving as a constructive diagnostic and motivational tool., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author(s).)

Aim: Craniofacial abnormalities such as maxillary retrusion, mandibular retrognathism, short mandibular body, and downward and backward rotation of the mandible in hyperdivergent patients are considered to be the most important risk factor for upper airway obstruction. The aim of the study is to analyze the influence of maxillary and mandibular morphology on pharyngeal length. Materials and Methods: The study sample includes 146 pretreatment lateral cephalographs of both male and female patients aged between 18 and 30 years. The study sample was divided into three groups: Group I – Class I skeletal relationship, Group II – Class II, and Group III – Class III. Each group is further divided into three subgroups according to the growth pattern (A – horizontal, B – average, and C – vertical). The lateral cephalograms were traced both manually and digitally using FACAD imaging software. Results: Comparison of mean maxillary, mandibular, and airway dimensions done using one-way analysis of variance proclaims that the means of all the parameters of the study are statistically significant with P < 0.05 except the upper pharyngeal space. Pearson correlation test reveals a statistically significant positive correlation between the height of the ramus and the lower pharyngeal space. Conclusion: The upper pharyngeal space is reduced in Class III, and the lower pharyngeal space is reduced in Class II and Class III malocclusions. The airway dimension decreased in vertical growth pattern in all the skeletal malocclusion groups. Upper and lower pharyngeal space has a negative correlation with ANS-PNS (maxillary length) and length of the body of the mandible, respectively. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the three‐dimensional changes following rapid maxillary expansion (RME) of the nasal cavity (NC) and pharyngeal airway (PA) in growing patients, using innovative and validated evaluation methods and to investigate whether a correlation between skeletal expansion and increase in airway volume exists. Settings and sample population: Records of patients who had cone beam computed tomography taken before and after orthodontic treatment with or without RME were retrospectively collected and divided into two groups: (a) RME, 39 patients (mean age 10.40 ± 1.74 years); and (b) control, 29 patients, matched for age (mean age 11.07 ± 1.45 years) and follow‐up period. Material and methods: Total and partial volumes of the NC and the PA were calculated. The PA centerline was determined to assess the minimal cross‐sectional area and hydraulic diameter. Paired and unpaired t test were applied to compare the difference between time points and between groups. One‐way ANOVA and post hoc Tukey's tests were used to compare subgroups with respect to changes in palatal width and lacrimal ducts distance. Results: All of the NC, PA and skeletal parameters were significantly enlarged after RME. The NC volume and inter‐molar distance in the RME were significantly larger compared to the control group. The initially lower mean values of minimal cross‐sectional area and hydraulic diameter in the RME group when compared to the control group normalized after RME treatment. Conclusions: Based on validated analyses, the NC volume increase was evident after RME in the long term after controlling for growth. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to evaluate an automatic segmentation algorithm for pharyngeal airway in cone‐beam computed tomography (CBCT) images using a deep learning artificial intelligence (AI) system. Setting and Sample Population: Archives of the CBCT images were reviewed, and the data of 306 subjects with the pharyngeal airway were included in this retrospective study. Material and Methods: A machine learning algorithm, based on Convolutional Neural Network (CNN), did the segmentation of the pharyngeal airway on serial CBCT images. Semi‐automatic software (ITK‐SNAP) was used to manually generate the airway, and the results were compared with artificial intelligence. Dice similarity coefficient (DSC) and Intersection over Union (IoU) were used as the accuracy of segmentation in comparing the measurements of human measurements and artificial intelligence algorithms. Results: The human observer found the average volume of the pharyngeal airway to be 18.08 cm3 and artificial intelligence to be 17.32 cm3. For pharyngeal airway segmentation, a dice ratio of 0.919 and a weighted IoU of 0.993 is achieved. Conclusions: In this study, a successful AI algorithm that automatically segments the pharyngeal airway from CBCT images was created. It can be useful in the quick and easy calculation of pharyngeal airway volume from CBCT images for clinical application. [ABSTRACT FROM AUTHOR]

Objectives: To test the hypothesis that there is no positive correlation between skeletal Class II and mandibular morphology with pharyngeal dimensions in subjects with different growth patterns. Materials and Methods: Lateral cephalograms of 60 patients were collected and divided into 2 groups, comprising of 30 in each group. Group 1 consisted of cephalograms of patients having Class I malocclusion, and was further divided into subgroups. 1a) Class I with normal growth 1b) Class I with vertical growth. Group 2 consisted of cephalograms of patients having class II malocclusion and was further divided into subgroups 2a) Class II with normal growth, 2b) Class II with vertical growth. Results: The results showed that the estimated marginal mean for upper pharyngeal width in class I malocclusion group was 8.56 mm, for class II malocclusion group was 7.80 mm, for normal growth individuals was 9.73 mm and that for vertical growth individuals was 6.63 mm. The estimated marginal mean for lower pharyngeal width in class I malocclusion group was 9.62 mm, in class II malocclusion group was 9.10 mm, in normal growth individuals was 8.95 mm and that in vertical growth individuals was 9.77 mm. The estimated marginal mean for pharyngeal area in class I malocclusion group is 330.13 sq.mm, in class II malocclusion group is 308.17 sq.mm, in normal growth individuals is 328.47sq.mm and that in vertical growth individuals is 309.83 sq.mm. Conclusions: The null hypothesis for this study, as per the statistical analysis, has been rejected. [ABSTRACT FROM AUTHOR]

Background/aim: The objectives of this study were to assess pharyngeal airway volume (PAV) in patients with myotonic dystrophy type 1 (DM1) by cone-beam computerized tomography (CBCT) and to evaluate the impact of diaphragm thickness and pulmonary function tests on PAV. Materials and methods: Thirty DM1 patients (10 female and 20 male; mean age 42.40 ± 12.07) were included in the study. Age and sex-matched thirty patients were participated as control group. In DM1 group pulmonary function tests (PFT) were performed. Independent t-test was used to compare PAV values of patients with DM1 and control group. The Mann–Whitney U test was used to compare the parameters according to sex (p < 0.05). Pearson and Spearman correlation tests were used to evaluate the relationships between parameters of DM1 patients (p < 0.05). A multiple linear regression analysis was performed to explain the PAV with parameters that showed positive correlation with PAV. Results: Age of onset and disease duration were 22.37 ± 8.45 and 20.03 ± 12.08, respectively, in patients with DM1. PAV values of control group were significantly lower than DM1 group (p < 0.001). Forced expiratory volume in 1 s and forced volume vital capacity values were higher in males than females in DM1 group according to sex (p < 0.001). PAV values were greater in male patients than females of the DM1 group (p = 0.022). Diaphragm thickness in DM1 group after inspiration and expiration were 2.60 ± 0.65 and 1.94 ± 0.40, respectively. According to the regression analysis, DTai and FVC were significantly explained the PAV. Conclusion: PAV was higher in DM1 group. There was a significant positive correlation between diaphragm thickness, pulmonary functions, and PAVs of DM1 patients. The amount of the PAV was mostly influenced by DTai and FVC. It is recommended to evaluate the PAV in patients with DM1 because of impaired respiratory functions and pharyngeal muscle involvement. [ABSTRACT FROM AUTHOR]

Objective: This study sought to evaluate the effects of different maxillary protraction methods on the pharyngeal airway in Class III patients with maxillary retrognathia. Setting and Sample Population: A total of 59 individuals (31 females and 28 males) with a mean age of 11.38 ± 1.24 years were included in this study. Material and Methods: Fifty‐nine treated maxillary retrognathic patients who underwent different protraction methods were evaluated. Twenty patients treated with RME (Rapid Maxillary Expansion) made up the first group, and 20 patients treated with 5‐week Alt‐RAMEC (Alternate Rapid Maxillary Expansion and Constriction) protocol comprised the second group. Lastly, 19 patients on whom face masks with miniplates were applied were included in the skeletal anchorage (SA) group. Sixteen linear and four areal pharyngeal airway measurements were made on lateral cephalograms before and after treatment. Differences between the groups were assessed using analysis of variance (ANOVA) tests. Results: The mean maxillary protraction levels were determined as 2.7, 3.69 and 4.01 mm in the RME, Alt‐RAMEC and SA groups, respectively. In the nasopharynx, AD1‐PNS, AD2‐PNS, PNS‐Ba and PNS‐Ho measurements revealed a significant increase in the SA group compared to the other groups (P <.05). In the oropharynx, PNS‐Ep measurement increased significantly in the RME group (P <.05). In the total pharyngeal airway area, an increase was detected in the SA, Alt‐RAMEC, and RME groups. Conclusion: The most effective protraction method in terms of pharyngeal airway dimensions, especially in the nasopharynx, is the application of the face mask with skeletal anchorage. A greater increase in vertical airway length (PNS‐Ep) was observed with RME. [ABSTRACT FROM AUTHOR]

Background/purpose: The hyoid bone and its attached muscles play an important role in the maintenance of the pharyngeal airway space. The aim of the present study was to investigate the correlations between hyoid bone and pharyngeal airway spaces among three skeletal patterns. Materials and methods: Cephalograms of 90 male and 90 female were divided into skeletal patterns: Class I, Class II, and Class III. The following pharyngeal airway spaces were measured: SP, soft palate related pharyngeal airway; BP, B point related pharyngeal airway; C2P, second cervical vertebra related pharyngeal airway; and LP, laryngopharyngeal airway. The paired t-test, one-way analysis of variance, and Pearson correlation analysis were used in the statistical analyses. Results: SP was significantly longer in Class III (12.4 mm) than in Class I (10.7 mm) and Class II (9.5 mm), and BP was significantly greater in Class III (16.3 mm) than in Class II (12.4 mm). The hyoid bone had a significantly anterior location in Class III compared to Class II, whereas vertical positions of the hyoid bone showed no significant differences among the three skeletal patterns. Among female with a Class III skeletal pattern, the horizontal position of the hyoid bone had a positive moderate, significant correlation with the C2P, whereas among male, this was not observed. Conclusion: The location of the maxilla (SNA) was not significantly correlated with the pharyngeal airway space. However, the more protruding the mandible (SNB) is, the more anterior the hyoid bone and the longer the pharyngeal airway will be.

Introduction: After a century of controversies, we are still not certain on the relationship between airway volume and facial morphology.Objective: To measure nasopharyngeal airway volume and compare it among different skeletal patterns.Materials and methods: Forty five CBCT scans of patients between sixteen to twenty five years were used in the study. The nasopharyngeal airway was divided into upper, middle and lower segments. CBCT images were grouped into skeletal class I, class II and class III.Results: There was highly significant difference in upper (p=0.001) and middle pharyngeal airway volume (p

Introduction: Obstructive Sleep Apnea Syndrome (OSAS) regulate pharyngeal airway volume. Forward displacement of mandibular repositioning appliances has advantage over an improvement of pharyngeal airway space and a change in the hyoid bone position. This study aims to assess the changes in the pharyngeal airway dimensions and hyoid bone position in growing individuals with retrognathic mandible treated with Fixed Twin Block (FTB) and Forsus Fatigue Resistant Device (FRD) to correct the skeletal Class II pattern. Materials and Methods: 40 skeletal Class II pattern patients were included in the study, to assess the pharyngeal airway space at three levels, upper pharyngeal width (UPW), middle pharyngeal width (MPW), and lower pharyngeal width (LPW). Hyoid bone measurements were Vertical dimension H-HOR and Horizontal dimension was H- VER. The study patients were divided into three groups and in each group 20 patients. Group-A treated with FTB appliance and Group-B treated with Forsus FRD appliance and Group C served as control group. At pre and post functional treatment condition, lateral cephalograms were evaluated. Results: Cephalometric analysis revealed a significant increase in the mean change of MPW (P = 0.005) between the FTB and the control group. There was significant, mean change seen of pre, post UPW, mean change of MPW over groups (P

Objective: A two-dimensional cephalometric study was carried out to assess the airway among individuals with Class I and Class II skeletal base. Materials and Methods: Class II subjects were further categorized into horizontal and vertical growers and average growth patterns to check the possible relationship between the facial skeleton and pharyngeal airway. Lateral cephalograms of 150 subjects were obtained using standard protocol in natural head position (NHP). Nasopharyngeal and oropharyngeal linear, and angular and nasopharyngeal area measurements were obtained using standardized tracing technique. Analysis of variance (ANOVA), level of significance, and post hoc Turkey’s test were performed to assess the correlation between skeletal pattern of the individual and airway dimension. Gender discrimination was assessed using independent sample t test. Results: In linear measurements, significant differences were observed among upper pharynx (0.039), adenoid tissue 1 (0.036), and adenoid tissue 2 (0.01). In angular measurements, differences were observed with angle of nasopharynx (0.008). The nasopharyngeal area measurements were also associated with significant difference (0.038) with Class II vertical growers less than those with Class I average and Class II horizontal groups. Conclusion: Class II vertical growers had significantly reduced nasopharyngeal airways.

The aim of this study was to evaluate the effects of a partial glossectomy on volumetric changes of pharyngeal airway space (PAS) in patients with mandibular setback surgery. Overall, 25 patients showing clinical features related to macroglossia treated with mandibular setback surgery were included in this retrospective study. Subjects were divided into two groups: the control group (G1, n = 13, with BSSRO) and the study group (G2, n = 12, with both BSSRO and partial glossectomy). The PAS volume of both groups was measured by the OnDemand 3D program on CBCT taken shortly before operation (T0), 3 months post-operative (T1), and 6 months post-operative (T2). A paired t-test and repeated analysis of variance (ANOVA) were used for statistical correlation. Total PAS and hypopharyngeal airway space were increased after operation in Group 2 compared to Group 1 (p < 0.05), while oropharyngeal airway space showed no significant statistical difference with the tendency of increasing. The combination of partial glossectomy and BSSRO surgical techniques had a significant effect on increasing the hypopharyngeal and total airway space in class III malocclusion patients (p < 0.05).

Temporomandibular joint (TMJ) ankylosis results in malocclusion, poor feeding, difficulty in maintaining oral hygiene, and facial esthetic deformity. The basic surgical objectives in the treatment of TMJ ankylosis are to establish joint movement, prevent relapse, and achieve normal growth and development. Here, we present an operated case ofsurgical correction of mandibular hypoplasia; however, the patient came back after three years due to unsatisfactory results and underwent bilateral coronoidectomy and gap arthroplasty. Bones were osteotomized at the LeFort I level and the maxillary segment was down-fractured and mobilized to bring into occlusion with the mandible. In the present case, the lower pharyngeal airway changed from 5 mm pre-treatment to 10 mm post-treatment, and the facial angle was changed from 73 to 84 post-treatment. Assessment of the pharyngeal airway is done with a high suspicion of obstructive sleep apnea and facial deformity is mandatory in the management of TMJ ankylosis., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Mishra et al.)

Background: This study evaluated the pharyngeal airway space changes up to 1 year after bilateral sagittal split osteotomy mandibular setback surgery and bimaxillary surgery with maxillary posterior impaction through three-dimensional computed tomography analysis. Methods: A total of 37 patients diagnosed with skeletal class III malocclusion underwent bilateral sagittal split osteotomy setback surgery only (group 1, n = 23) or bimaxillary surgery with posterior impaction (group 2, n = 14). Cone-beam computed tomography scans were taken before surgery (T0), 2 months after surgery (T1), 6 months after surgery (T2), and 1 year after surgery (T3). The nasopharynx (Nph), oropharynx (Oph), hypopharynx (Hph) volume, and anteroposterior distance were measured through the InVivo Dental Application version 5. Results: In group 1, Oph AP, Oph volume, Hph volume, and whole pharynx volume were significantly decreased after the surgery (T1) and maintained. In group 2, Oph volume and whole pharynx volume were decreased (T2) and relapsed at 1 year postoperatively (T3). Conclusion: In class III malocclusion patients, mandibular setback surgery only showed a greater reduction in pharyngeal airway than bimaxillary surgery at 1 year postoperatively, and bimaxillary surgery was more stable in terms of airway. Therefore, it is important to evaluate the airway before surgery and include it in the surgical plan. [ABSTRACT FROM AUTHOR]

Background: The pharyngeal airway is a crucial part of the respiratory system’s function. Assessing the pharyngeal airway dimensions in different skeletal types is important in the orthodontic treatment of growing patients. The aim of this study was to compare the upper pharyngeal airway dimensions of 7–14-year-old children with different skeletal types. Methods: Three-hundred-sixty-one lateral cephalometric radiographs were grouped based on their skeletal patterns determined by the ANB angle as skeletal type I (n = 123), type II (n = 121), and type III (n = 117). The radiographs were divided into 4 groups: 7/8 YO (7–8 years old), 9/10 YO, 11/12 YO, and 13/14 YO. The cephalometric measurements comprised SNA, SNB, ANB, Ad1-PNS, Ad2-PNS, McUP, and McLP. An ANOVA was used to compare the group results. Results: Significant differences in Ad1-PNS, Ad2-PNS, McUP, and McLP in skeletal types II and III were found between age groups. Most upper pharyngeal airway dimensions in skeletal types II and III children were significantly wider in the 13/14 YO group than in the other age groups. Conclusion: The upper pharyngeal airway dimensions increased age-dependently in 7–14-year-old children, especially in skeletal types II and III. The upper pharyngeal airway dimensions could serve as a guide in differentiating the different skeletal classes in clinical settings.

Proper breathing is essential to healthy growth and development of children. The present study aimed to investigate changes in the pharyngeal airway space in primary-school children. Cephalometric radiographs were obtained from 93 primary-school children, who were divided into three age groups (Group I, aged 7–8 years; Group II, aged 9–10 years; and Group III, aged 11–12 years). Landmarks identified on each cephalogram included the tip of the uvula (U), hyoid bone (H), and epiglottis (E). Linear and angular measurements comprised nasopharyngeal airway (NP); PS (shortest distance from the soft palate to the pharyngeal wall); UP (distance from the tip of the uvula to the pharyngeal wall); TS (shortest distance from the posterior tongue to the pharyngeal wall); EP (distance, parallel to the X-axis, from the epiglottis to the pharyngeal wall). Statistical analysis was performed using one-way analysis of variance and Pearson correlation tests. Group III had the highest values for all the variables. The three groups exhibited significant differences for all pharyngeal airway variables, except for EP. The three groups had significantly different vertical U, H, and E. There were positive correlations between age and NP, PS, UP, and TS; however, no significant correlation was observed between age and EP. Age significantly correlated with the vertical U, E, and H. Correlations between age and the horizontal U, E, and H were nonsignificant. Among primary-school children from various grades, age significantly correlated with all pharyngeal airway variables, except with EP. [ABSTRACT FROM AUTHOR]

After a century of controversies, we are still not certain on the relationship between airway dimensions and facial morphology. Objective: The objective of the study was to measure nasopharyngeal airway dimensions and compare it among different skeletal patterns. Materials and Methods: Forty-five cone-beam computed tomography (CBCT) scans of patients between 16 and 25 years were used in the study. The nasopharyngeal airway was divided into upper, middle, and lower segments. CBCT images were grouped into skeletal Class I, Class II, and Class III. Results: There is no statistically significant difference between all the three groups for mean height of the upper, middle, and lower pharyngeal airways (P = 0.303, 0.479, and 0.077, respectively). There is no statistically significant difference between all the three groups for mean width of the upper, middle, and lower pharyngeal airways indicated by P = 0.643, 0.791, and 0.99, respectively. There is no statistically significant difference between all the three groups for mean breadth of the upper, middle, and lower pharyngeal airways (P = 0.939, 0.48, and 0.068, respectively). Furthermore, the mean total height of pharyngeal airway in Class I, Class II, and Class III groups indicates no statistically significant difference (P = 0.097). Conclusion: Nasopharyngeal airway dimensions seem to play no role in different skeletal patterns.

Objective: This study aims to evaluate the pharyngeal airway dimensions among Chinese adults in relation to Class I and Class II facial skeletal patterns using three-dimensional cone-beam computed tomography (CBCT) images. Materials and Methods: A total of 156 initial CBCT images were evaluated, which were classified into skeletal Class I and Class II according to ANB angle with mean (SD) age being 22.56 ± 4.0 years and 22.32 ± 3.6 years. The pharyngeal airway volume, airway area, minimum cross-sectional area (MCA) and the distance from uvula (tip of the soft palate) to mental spine (U-MS distance) were assessed with Dolphin imaging software. Results: Compared with Class I group, Class II group displayed significantly smaller pharyngeal airway volume, airway area and MCA (P