Aim: To cephalometrically evaluate the alterations taking place in the pharyngeal airway space, hyoid bone, soft palate, and head posture after mandibular setback surgery (bilateral sagittal split osteotomy) for correction of mandibular prognathism, as well as to evaluate the immediate postsurgical and more than 6 months postsurgical adaptations of these structures. Setting and Design: A retrospective cephalometric study. Materials and Method: The study group consisted of 40 nongrowing patients (20 females and 20 males) with mandibular prognathism and ANB less than or equal to –2 degree for which mandibular setback surgery by bilateral sagittal split ramus osteotomy was performed along with fixed appliance therapy. There presurgical (T1), immediate postsurgical (T2), and more than 6 months postsurgical (T3) lateral cephalograms were analyzed. Statistical Analysis Used: Intragroup comparison was done by paired t-test. Results: Skeletal measurements after orthognathic surgery remained stable in the long term. It was evident that mandibular setback surgery narrowed the pharyngeal airway; however, these changes were not significant except at the base of the tongue. During the follow-up airway measurements at the base of the tongue, the intersection of tongue at the inferior border of mandible and the vallecula increased but they did not reach the presurgical values. Soft palate length increased significantly after surgery. Angulation of soft palate to nasal line also increased significantly following surgery but decreased during follow-up. Extension of the head occurred after surgery which was maintained even at long term. Conclusion: Careful analysis of airway should be performed, particularly in connection with large anteroposterior discrepancies and in those who have risk factors for development of obstructive sleep apnea. Such cases should be corrected by combined maxillary and mandibular osteotomies.
Changes in Pharyngeal Airway After Mandibular Setback Surgery: A Retrospective Cephalometric Study