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The Effect of Bimaxillary Surgery on the Airway Morphology in Class III Patients

Taking Into Account the Head Posture During Walking

Kiliç, Banu, DDS*; Amuk, Nisa Gül, DDS; Hacioğlu, Zeynep, DDS; Demirbaş, Ahmet Emin, DDS

doi: 10.1097/SCS.0000000000005495
Original Article: PDF Only

Objectives: To assess changes in head and neck posture, airway, hyoid, tongue, and soft palate in skeletal class III individuals whose cephalograms were taken using dynamic natural head positioning method with an inclinometer.

Materials and Methods: This study was conducted on 20 class III patients operated with double jaw surgery. Natural head positions were determined before and 6 months after the surgery. Craniocervical, pharyngeal airway, tongue, and hyoid positions were measured. In the analysis of the data, paired t test, independent sample t test and correlation tests were used.

Results: There was a statistically significant change in the craniocervical measurements with the operation and the head position was further extended (P < 0.05). Significant changes were observed in the soft palate angles upon surgery (P < 0.026) and the increase in oropharyngeal airway area was statistically significant (P < 0.001). There was a statistically significant increase in tongue length (TL) and distance from vertical reference plane to tongue tip (TTi/VRP) measurements (P < 0.001 and P < 0.012, respectively). There was a statistically significant decrease in distance from horizontal reference plane to tongue tip (TTi/HRP) and tongue dorsum (TD/HRP) measurements (P < 0.033 and P < 0.003, respectively). The only significant change among the hyoid bone position-related measurements was distance between hyoidale and epiglottis (P < 0.013).

Conclusions: Hyoid bone location, tongue measurements, and posterior pharyngeal airway were found to be related to each other and they have been found to be effective on the head and neck posture. Head position will be affected by possible surgical alternatives.

*Department of Orthodontics, Faculty of Dentistry, Bezmialem Vakif University, Istanbul

Department of Orthodontics

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, Kayseri, Turkey.

Address correspondence and reprint requests to Banu Kiliç, DDS, Bezmialem Vakif Universitesi Sahilyolu Street No:16 34844 Maltepe, Istanbul, Turkey; E-mail:

Received 26 September, 2018

Accepted 13 February, 2019

The authors report no conflicts of interest.

© 2019 by Mutaz B. Habal, MD.