Pharyngeal Width Research Articles

Pharyngeal airway dimensions and hyoid bone position in children with class II malocclusion and sleep problems: A cross sectional study

ObjectiveTo evaluate the pharyngeal airway width and hyoid bone position in children with class II malocclusion and a positive history of sleep problems. Methods60 children aged 8–12 years with skeletal class II malocclusion were segregated into two groups according to the existence of sleep problems: 30 participants with sleep disorders constituted the study group, while 30 participants without sleep disorders formed the control group. Pharyngeal airway space and hyoid bone position were evaluated via a clinical and radiographic examination. ResultsA significantly narrower upper pharyngeal airway width and decreased C3-H hyoid parameter was noted in children with sleep problems (p = 0.035, 0.012). ConclusionBoth pharyngeal airway parameters and the hyoid bone parameters could be potential risk indicators while screening for sleep-disordered breathing in children.

Pharyngeal width comparison in different skeletal malocclusions and growth patterns of Nepalese population

Context: Regarding the relationship between the size of the pharynx and several sagittal skeletal malocclusions and patterns of growth, contradictory findings have been documented. Aims: The intent of this research was to analyze the size of the pharynx in various sagittal malocclusions and growth patterns in the Nepalese population. Settings and Design: An analytic cross-sectional research was undertaken on patients who attended the Orthodontics Division of BPKIHS. Materials and Methods: A total of 135 patients’ lateral cephalometric radiographs were gathered. Medians and interquartile ranges of pharyngeal widths according to McNamara airway analysis and Arnett/Gunson FAB airway analysis adapted by Santiago et al. in different skeletal malocclusions and growth patterns were compared. Results: There was not any discernible statistically noteworthy variation within the upper pharynx size, lower pharyngeal width, nasopharyngeal width (WNP), oropharyngeal width, hypopharyngeal width (WHP), and deep pharyngeal width (WDP) in different skeletal malocclusions. A statistically significant variation was discovered in nasopharyngeal size (P = 0.010), hypopharyngeal size (P = 0.027), and deep pharyngeal size (P < 0.001) in various patterns of growth, i.e. hypodivergent versus normodivergent, and in hypodivergent versus hyperdivergent, not in normodivergent versus hyperdivergent group of patients. Conclusion: There was not anything statistically noteworthy variation in the pharyngeal widths of the participants with respect to the various skeletal malocclusions. WNP, WHP, and WDP showed a statistically significant variation between hypodivergent versus normodivergent and hypodivergent versus hyperdivergent growth patterns.

Pharyngeal Structure and Dysphagia in Patients with Parkinson's Disease and Related Disorders.

Pharyngeal muscle changes occur in patients with Parkinson's disease and related disorders (PRD); however, the association between the structural alterations in the pharynx and the symptoms of dysphagia remains unclear. We assessed structural changes and contractile forces by measuring pharyngeal wall thickness and width. We aimed to define the pharyngeal measurements and determine their value as diagnostic tools for dysphagia.The pharyngeal wall thickness (PWT), pharyngeal width at rest (PWR), and shortest pharyngeal width at swallowing (PWS) were measured using lateral neck roentgenograms and videofluoroscopic swallowing study. We compared the PWR and PWT between the PRD and control groups using an independent t-test. The Kendall correlation test was performed on the radiological data of the pharynx (PWT, PWR and PWS), dysphagia scales (Penetration-Aspiration scale [PAS] and Dysphagia Outcome and Severity Scale [DOSS]), and Hoehn and Yahr scale (HY scale).The PWT was smaller and the PWR greater in the PRD than in the control group (p < 0.05). The dysphagia scales (PAS and DOSS) were correlated with the radiological data (PWT and PWS) and the HY scale (p < 0.05). The HY scale score also correlated with the PWT (p < 0.05). The optimal cutoff points of the PWT and PWR for predicting aspiration were 4.05 and 16.05mm in the PRD group, respectively.Using the PWT, PWR and PWS, muscle atrophy and contractile strength of the pharynx can be estimated. The combination of the PWT and PWR can be a simple indicator for predicting swallowing disorders at the bedside.

Phonetic correlates to Khalkha Mongolian vowel contrasts: duration, formants and voice quality

The paper reports the results of an analysis of acoustic correlates to phonological contrasts in vowel length, quality and pharyngeal width with data from five native speakers of the Khalkh dialect. The study replicates Svantesson’s (1985) discovery of a chain-shift rotation of the round vowels in their presumed evolution from Classical Mongolian. Analysis with VoiceSauce (Shue et al. in: Proceedings of the ICPhS XVII, 1846–1849, 2009) finds that in addition to the first formant, the harmonics-to-noise ratio is a reliable indicator of the ATR versus RTR contrast that has been hypothesized to be the basis of the language’s vowel harmony.

A Cephalometric Study of Pharyngeal Dimensions Following Twin Block Treatment

Objective: To assess and compare changes in pharyngeal airway widths (PAW) using lateral cephalograms before and after treatment with a removable twin block appliance. Methodology: Lateral cephalogram records were taken before (T0) and after (T1) the treatment of 50 Class II subjects (ANB&gt;40; 28 males, 22 females; mean age 12.6 years) using the removable twin block appliance. The study period spanned 12 months. Airway volumes, including upper airway width (UAW), middle airway width (MAW), and lower airway width (LAW), were compared between T0 and T1. The data were analyzed using SPSS statistical software via paired t-test. A p-value of ?0.05 was considered statistically significant. Results: A total of 50 patients were included in the study, and airway changes were analyzed at two different times prospectively (T0 and T1). The male-to-female ratio was 1:0.8 (44% females, 56% males). The mean upper airway width (UAW) at T0 and T1 was 14.04 mm and 15.3 mm, respectively. The mean middle airway width (MAW) at T0 and T1 was 8.8 mm and 11.8 mm, respectively, while the mean lower airway width (LAW) at T0 and T1 was 7.5 mm and 10.2 mm, respectively. The mean age was 12.6 years, and the mean BMI was 21. The mean SN-Md angle was 31.8 degrees. At T1, a significant increase in airway volume was observed in upper airway width (UAW), middle airway width (MAW), and lower airway width (LAW) (P=0.000). Conclusion: Treatment with the Twin Block Appliance in growing subjects resulted in an increase in the overall posterior pharyngeal airway volumes.

Supine Pharyngeal Width Is Associated With Complete Concentric Palatal Collapse During Drug-Induced Sleep Endoscopy and Hypoglossal Nerve Stimulator Outcomes.

Hypoglossal nerve stimulation (HNS) implantation in the US requires preoperative drug-induced sleep endoscopy (DISE) screening for complete concentric palatal collapse (CCC) to establish treatment candidacy. We hypothesized that supine pharyngeal width (SPW) in awake patients is associated with CCC and HNS therapy outcomes. Adults with moderate to severe obstructive sleep apnea underwent awake measurement of SPW followed by DISE screening for CCC. Eligible patients electing for HNS implantation underwent postoperative polysomnography per standard of care. SPW was measured in 73 patients. For SPW >20mm, the positive likelihood ratio for absence of CCC was 6.67 with pre- and post-test odds of 6.3 and 42.0, respectively. Postoperative PSG data were available from 31 of 44 (70.5%) patients subsequently implanted with HNS. Patients with SPW >20mm had a greater rate of HNS response than those with SPW ≤20 (62 vs 30%; P < .05). Only SPW and BMI were significantly associated with CCC and HNS response in regression models. In a retrospective cohort study, SPW was significantly associated with CCC and postoperative apnea-hypopnea index following HNS implantation. SPW may be a viable screening tool for HNS candidacy.

RELATIONSHIP BETWEEN THE POSITION OF HEADS OF TEMPOROMANDIBULAR JOINT AND UPPER RESPIRATORY TRACT IN MALOCCLUSION CLASS I AND II

The respiratory organs and the maxillofacial apparatus are quite closely related to each other. Reducing the size of the upper respiratory tract is a factor that contributes to the development and formation of bite pathology and even dysfunction of the temporomandibular joint (TMJ). In recent years, there has been an increase in the prevalence of maxillofacial anomalies among children. The aim of the study Is to determine and to compare the position of the TMJ heads and the anatomical dimensions (anterior-posterior dimensions) of the upper respiratory tract in patients with malocclusion class I and II bite based on cone beam computed tomography findings. The analysis of 39 cone-beam computer tomograms of patients was carried out. According to the ANB angle, all patients were divided into two groups based on the type of malocclusion: group I included patients with malocclusion class I, and group II included patients with malocclusion class II. Measurement and interpretation of cone-beam computer tomography was carried out according to the method of N.A. Rabukhina and the McNamara’s method. The dimensions of the joint space of the temporomandibular joint in three sections (front, top and back both on the right and on the left) had no statistically significant differences. The average value of the joint space on the left and right in the patients of the first group in the front section was 2.5±0.27mm, in the patients of the second group – 3.01±0.35. In the upper part these indicators in patients of the first group were 2.76±0.37 mm, in the second group - 2.65±0.32 mm. In the posterior part the average value of the joint’s gap was 3.06±0.01 mm in patients of the first group and 2.28±0.27 mm in the second group. Measurements of the oropharyngeal area on cone-beam computed tomography were (according to the McNamara’s method): the width of the upper part of the pharynx in the first group - 17.41±0.44 mm, and in the second group averaged 15.82±0.61 mm with statistical significance (р˂0.05). In patients with bite pathology of both classed, according to the McNamara’s method, the lower part of the pharynx is narrowed compared to the norm. The study demonstrated the patients of the II group have a statistically significant difference in the reduction of the pharyngeal upper part width compared to I group and the displacement of the TMJ heads upwards and backwards.

Build and breathing – Is there an association?

Normal breathing is essential for the harmonious craniofacial growth. Narrowing or functional impairment of the airway can lead to obstructive sleep apnoea (OSA). Orthodontists are well positioned to carry out a screening of OSA and refer the patients-at-risk for further diagnostic valuation by the physician. The aim of this research was to evaluate the presence of a correlation between the build of the patient and airway insufficiency to sensitize the eye of the orthodontist for potential at-risk OSA patients and provide a superior quality of treatment for them. Pre-treatment lateral cephalograms of 45 patients were divided into three groups depending on the build of the patient, i.e., endomorphic, mesomorphic and ectomorphic. The BMI was calculated for each individual and all were evaluated for the presence of airway insufficiency using McNamara’s pharyngeal width analysis. The positions of the hyoid bone and the tongue posture was also evaluated. The results of the present study showed that the association between the overall McNamara airway measurements and the build of the patient was statistically insignificant. A statistically significant difference was found between the association of the two sexes with the upper pharyngeal width values and the BMI values with the males showed a higher risk for airway insufficiency. This study suggests that build of the patient cannot be considered as a screening factor for airway insufficiency or OSA. However, a significant correlation exists between the airway insufficiency and the sex of the patient with a higher predilection of upper airway insufficiency in males.

Assessment of Dentofacial Characteristics and Pharyngeal Airway in Children with Class II Malocclusion and Mouth Breathing

Abstract 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.

Comparison of Pharyngeal Airway Width among Individuals having Skeletal Class I Malocclusion with Different Growth Patterns

Introduction: An interaction can be seen between respiratory function and the maxillary growth pattern. Therefore, this study was conducted to assess and compare the pharyngeal airway width of individuals with different growth patterns in skeletal class I malocclusion. Materials and Method: Analytical cross-sectional study was done to assess total of 60 cephalometric radiographs of individuals with skeletal class I malocclusion pattern selected through convenience sampling method. McNamara analysis was done to measure the width of upper and lower pharyngeal space. Statistical analysis was done in SPSS version 20. One way ANOVA and Post Hoc test were done to determine the mean difference of upper and lower pharyngeal airway space width in between individuals of skeletal class I malocclusion with different growth pattern. Result: There was no significant mean difference in upper pharyngeal airway space (p=0.201) seen in between three growth patterns of individuals with class I malocclusion. However, the study participants with vertical growth pattern showed significantly less lower pharyngeal space width (8.36±2.63mm) than in horizontal growth pattern (10.89±3.46 mm, p=0.028). Conclusion: The findings of this study conclude that in skeletal class I malocclusion, there is no difference in upper pharyngeal space dimensions among individuals with different growth patterns but the vertical growth pattern shows smaller dimension of lower pharyngeal space than horizontal growth pattern.

PHARYNGEAL AIRWAY SPACE IN DIFFERENT SKELETAL MALOCCLUSION AND FACIAL FORMS

Background: Evaluation of the upper and lower airway space should be an integral part of diagnosis and treatment planning to achieve the functional balance and stability of the result after orthodontic or orthognathic treatment. This study aimed to analyze the pharyngeal airway space in different skeletal malocclusion and facial forms. Methods: Study was carried out in lateral cephalometric radiographs of 210 patients. Data was collected from March 2021 to December 2021. Pharyngeal airway spaces were analyzed according to McNamara Analysis. Upper and lower pharyngeal airway in different skeletal malocclusion and facial form was determined. Data was analyzed in SPSS version 20. Independent samples-t test was applied for gender distribution and Pearson correlation test was applied for upper and lower pharyngeal space. Results: The mean value of upper pharyngeal airway width in Class I, II and III were 12.07 mm, 11.57 mm and 12.34 mm respectively and for Mesofacial, Dolichofacial and Brachyfacial facial form were 12.35 mm, 11.83 mm and 11.81 mm respectively. Similarly, the mean value for lower pharyngeal airway width in Class I, II and III were 9.51 mm, 9.13 mm and 10.03 mm respectively and for Mesofacial, Dolichofacial and Brachyfacial facial form were 9.62 mm, 9.34 mm and 9.61mm respectively. Male had higher value of mean lower pharyngeal width than female. Conclusions: There was no impact of sagittal skeletal malocclusion on the upper and lower airways width. Also, there was no impact of different vertical skeletal types or facial forms on the upper and lower airways width.

Cephalometric evaluation of the main airway dimensions in subjects with different growth patterns and their relationship to patients&amp;apos; ages and genders

Background: Airway shape and dimensions have attracted attention during the past few decades; this can be attributed to the relationship between the upper airway configuration and sleep-disordered breathing and its relationship with craniofacial morphology in general. This study was conducted to 1. Compare the pharyngeal dimensions of subjects with different vertical growth patterns and 2. Assess the impact of modifying variables, like age and gender, on the airway dimensions. Methods: Data collection was based on both cephalometric radiographs and patients\&amp;apos; files analysis. Radiographs were grouped according to patients\&amp;apos; ages, genders, and vertical growth patterns. Lateral cephalometric radiographs were taken using a standardized technique. The simple network management angle was used to divide the sample into hypodivergent, noromodivergent, hyperdivergent growth patterns with 38&amp;#xb0;, respectively. The upper and lower pharyngeal airway widths were measured by using McNamara\&amp;apos;s airway analysis. Results: The widest upper and lower pharyngeal widths (LPWs) were found among hypodivergent subjects (20.1 ± 2.3 and 11.6 ± 4, respectively), and gender differences were found in the upper pharyngeal width (UPW) but in the lower (17.4 ± 3.4 and 18.1 ± 3.5, 10.1 ± 2.3 and 10.2 ± 3.1) for males and females in the upper and lower airways, respectively. Increasing the subject\&amp;apos;s ages significantly increased the UPW but did not affect the LPW. Conclusion: Hypodivergent patients had a higher UPW and LPW compared to the noromodivergent and hyperdivergent growth patterns. Also, the UPW and LPW were slightly higher in females than in males and increasing age had significantly increased UPW but did not affect LPW.

Radıologıcal Evaluatıon of the Recesses on the Posterıor Wall of the Nasopharynx wıth Cone-beam Computed Tomography.

The posterior wall of the nasopharynx is composed of loose connective tissue that includes many important anatomical structures. Various structures, such as the opening of the Eustachian tube (ET), the Rosenmüller fossa (RF), and the pharyngeal bursa (PB) are found here. To evaluate the nasopharynx posterior wall anatomic structures, including the Eustachian tube, Rosenmüller fossa, and pharyngeal bursa with cone-beam computed tomography. The depth, width, and length of the Eustachian tube, Rosenmüller fossa, and pharyngeal bursa were measured in 150 patients using axial-sagittal cone-beam computed tomography. The Eustachian tube and Rosenmüller fossa distance to the midsagittal plane, the coronal region passing through the posterior end of the nasal septum, the superior-inferior extremity of the recesses, and the nasal floor plane distance were measured. The relationship between Rosenmüller fossa types and other parameters were evaluated. The incidence of right Rosenmüller fossa types 1, 2, and 3 were 16%, 18%, and 66%, respectively, and that of the left Rosenmüller fossa types 1, 2, and 3 were 16%, 19.3%, and 64.7%, respectively. The mean pharyngeal bursa width, length, and depth were 10.8, 5.7, and 4.0 mm, respectively; those of the Eustachian tube were 5.6, 7.1, and 7.3 m, respectively; those of the right Rosenmüller fossa were 4.0, 12.4, and 10.5 mm, respectively; and those of the left Rosenmüller fossa were 3.8, 12.5, and 10.9 mm, respectively. The posterior wall of the nasopharynx contains several important anatomical structures. Evaluation of these using cone-beam computed tomography has many clinical and radiological advantages. To understand and interpret the coincidental findings in CBCT, dental radiologists should have access to more detailed information concerning the anatomy of the nasopharynx.

Evaluation of pharyngeal airway width in relation to vertical facial types in children

The purpose of this retrospective study was to evaluate the pharyngeal airway width according to the vertical facial type in Korean children in the developmental stage. In total, 101 participants aged 7 - 11 years were selected and divided into three groups based on the mandibular plane angle. The size of pharyngeal airway width was assessed using lateral cephalograms. The data were statistically analyzed using one way ANOVA test and independent t-test.The vertical growth group showed significantly narrower nasopharyngeal and upper oropharyngeal airway width than that in the normal and horizontal growth groups. Lower nasopharyngeal airway width was the widest in the horizontal growth group and the difference was statistically significant. The vertical oropharyngeal airway space was significantly smaller in girls when compared to boys, and no distinct difference was observed between horizontal airway width of the sexes. The results from this study indicate that patients with vertical facial growth pattern had less pharyngeal airway width than the patients with normal and horizontal facial growth patterns.

The influence of pharyngeal width on post-stroke laryngeal aspiration.

Laryngeal penetration, which is a less serious form of aspiration, should be considered in patients with stroke to ensure early detection of risk of laryngeal aspiration and prevention of pneumonia. As a follow-up to a previous study that demonstrated the association of pharyngeal width to laryngeal aspiration, the present study sought to determine whether the pharyngeal width was related to not only laryngeal aspiration but also laryngeal penetration in patients with deglutition disorder following stroke. The pharyngeal width on the roentgenogram was measured and compared based on the severity of aspiration. Moreover, the optimal cut-off points were determined for predicting the penetration and aspiration so that the difference between the penetration and the aspiration could be elucidated. The pharyngeal width of the patients was wider than the controls. The increase of the pharyngeal width by aspiration severity was more evident in the patients with chronic and right cerebral stroke. The optimal cut-off point of the pharyngeal width was approximately 1 mm lesser for the prediction of penetration than for aspiration. The pharyngeal width could be an ancillary method for detecting penetration and aspiration in stroke patients.

English

BACKGROUND Skeletal malocclusions occur because of the defect in the underlying skeletal structure. Mandibular skeletal retrusion is the most common characteristic of class II malocclusion. The purpose of this study was to evaluate pharyngeal airway dimension in Class II patients treated with Herbst appliance and fixed mechanotherapy using cone beam computed tomography (CBCT). METHODS This comparative study was conducted among 30 Class II patients (9 to 15 years of age) selected from the outpatient department of orthopaedics. They were divided into 2 Groups; Group I (15 patients) was treated by Herbst appliance; Group II (15 patients) was treated by fixed mechanotherapy. Pharyngeal airway volume, length and width evaluation were done using CBCT in vivo dental software 5.1 (ANATOMAGE, San Jose, CA). Intergroup comparison was done using independent t tests and level of significance (P &lt; 0.05). Correlation of parameters were carried out using Pearson’s correlation test. RESULTS Significant increase in nasopharyngeal, velopharyngeal, glossopharyngeal, laryngopharyngeal, and total airway volume in Herbst group was observed. Velopharyngeal length, glossopharyngeal length and nasopharyngeal airway width showed significant increase in Herbst group. CONCLUSIONS Treatment of Class II patients with Herbst appliance resulted in increase in pharyngeal airway volume. Herbst therapy induced repositioning of tongue resulting in increased length due to posterior fall of uvula, and hence airway volume increased drastically. KEY WORDS Airway Volume, Herbst Appliance, Class II Malocclusion, Retrognathic Mandible

Changes in Airway Dimensions After Face-Mask Therapy in Cleft Lip and Palate and Non-cleft Patients: Systematic Review and Meta-Analysis

Context: Maxillary deficiency can lead to the reduction of airway space and increase the chances of development of obstructive airway disorders. Facemask therapy is one of the main treatment protocols in developing maxillary deficient patients. Objectives: The purpose of this systematic review and meta-analysis was to assess the changes in the airway dimensions after face-mask therapy in both cleft lip and palate and non-cleft patients. Methods: A systematic search in different electronic databases (EMBASE, Pubmed, Cochrance Central register of controlled trials), IADR proceedings and a hand search by October 2020 were conducted and a meta-analysis and systematic review was performed. Results: In patients without cleft lip and palate, upper pharyngeal width was significantly increased by mean of 2.05 mm (CI = 95%, 0.61 - 3.50) following facemask therapy in comparison to patients who did not receive the treatment. Other upper pharyngeal (nasopharyngeal) measurements also showed a statistically significant improvement after therapy: S-PNS by 4.64 mm (CI = 95%, 3.34 - 5.94), AD1-PNS by 3.81 mm (CI = 95%, 2.40 - 5.21), AD2-PNS by 2.90 mm (CI = 95%, 0.13 - 5.67) and Pm’-SPL by 2.53 (CI = 95%, 0.54 - 4.51). Lower pharyngeal measurments did not show any significant changes after the treatment (P &gt; 0.05). In the analysis of studies with 3D imaging modalities, upper pharyngeal volume was also significantly increased by 499.29 mm3 (CI = 95%, 69.58-929.00) after the treatment. In addition, a review of articles that included cleft lip and palate patients also showed after the treatment, the upper pharyngeal measurements all showed a significant improvement (P &lt; 0.05), whereas the oropharyngeal region was relatively stable. Conclusions: In maxillary deficient patients with or without an orofacial cleft, facemask therapy can improve the nasopharyngeal area dimensions; however, this treatment protocol appears not to have an effect on the oropharyngeal area of the airway tract.

Comparative assessment of changes in pharyngeal airway space in cases of obstructive sleep apnoea with a customized mandibular repositioning appliance - a clinical study

ObjectivesThe present study aims at evaluating the effects of a customized mandibular repositioning appliance on the pharyngeal airway, nocturnal sleep patterns, daytime discomfort and occlusal changes in established cases of adult obstructive sleep apnoea.Material and MethodsTen consecutive patients with a complaint of snoring and disturbed sleep were included in the study. The primary diagnosis was established by the Epworth sleepiness scale, clinical examination, history and subsequently the diagnosis was substantiated through assessment of the pharyngeal airway space on a lateral cephalogram and polysomnography. A customized mandibular repositioning appliance was used to advance the mandible sequentially every 6 months, using 4 sets of the appliance. Pre and post-treatment evaluations were performed to establish, effects and changes in the outcome of obstructive sleep apnoea.ResultsThe study revealed significant increase in the mean pharyngeal widths of upper airway and velum dimension with antero-superior repositioning of hyoid bone. Epworth sleepiness scale score improved significantly from baseline with clinically evident change in daytime discomforts. Significant decline in the mean apnoea/hypopnea index, oxygen desaturation index, respiratory disturbance index, heart rate, snoring and a significant increase in mean oxygen saturation of arterial blood was observed. No evident change noticed in occlusion except lower incisor inclination.ConclusionThe customized mandibular repositioning appliances are effective in the management of adult obstructive sleep apnoea with a significant improvement observed in the airway patency and polysomnography parameters with clinically non-significant effects on dental occlusion..

Correlation of Pharyngeal Airway Dimensions with Maxillomandibular Skeletal Relation and Mandibular Morphology in Subjects with Skeletal Class I and Class II Malocclusions and Different Growth Patterns: A Cephalometric Study in Selected Local Population.

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.

Correlation Between Pharyngeal Airway Space and Sagittal Skeletal Malocclusions

OBJECTIVE: To determine correlation between pharyngeal airway space and sagittal skeletal malocclusions. METHODOLOGY: Data was collected using pre-treatment records including pre-treatment lateral cephalograms of 54 orthodontic patients. Patients from both gender were included. The age group of selected patients was 15-25 years, Patients belonging to Pakistani ethnicity were included to avoid selection bias. Sagittal skeletal malocclusion was measured by ANB angle to group the skeletal Class I, II and III subjects (ANB=0-4°, ANB &gt; 4° and ANB &lt;0 respectively). Upper pharyngeal space and Lower Pharyngeal space was measured. This cross sectional study was conducted in Orthodontic OPD at Karachi Medical and Dental College, from August 2019 to March 2020. RESULTS: The obtained data showed strong negative correlation between ANB angle and upper pharyngeal space whereas moderately negative correlation between ANB angle and lower pharyngeal space. CONCLUSION: Upper and lower pharyngeal widths were influenced by Sagittal malocclusion. KEYWORDS: Pharyngeal airway space, Sagittal skeletal malocclusion, Obstructive sleep apnea, Sleep disordered breathing, ANB. HOW TO CITE: Siddiqui H, Rizwan S, Faisal SS, Hussain SS. Correlation between pharyngeal airway space and sagittal skeletal malocclusions. J Pak Dent Assoc 2020;29(4):217-222.