{'fraction_non_alphanumeric': 0.012706480304955527, 'fraction_numerical': 0.0019059720457433292, 'mean_word_length': 5.730769230769231, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Sequential Upper Airway Changes During Mandibular Distraction for Obstructive Sleep Apnea

Changes in upper airway morphology after surgical intervention for obstructive sleep apnea (OSA) are poorly understood even though it is generally accepted that surgery is effective as a result of increases in upper airway size, decreases in airway compliance, or both. Uvulopalatopharyngoplasty variably increases pharyngeal size and decreases critical closing pressures. Larger cross-sectional airway size has been observed after surgery in successful responders.1-3 Maxillofacial surgery and palatal advancement may alter lateral wall dimensions. It is widely believed that mandibular advancement moves the tongue forward to correct airway obstruction in the lower pharyngeal segment and tongue base. However, morphologic changes after surgical movement of the jaw may occur in airway segments other than the tongue base or lower pharynx. Studies that evaluate the morphologic effects after intervention with oral appliances and passive jaw thrust demonstrate significant and even greater changes in retropalatal than retroglossal airway size.4 The affects of surgical interventions on the airway are less well understood. We present the unique case of an adult with OSA that allowed for serial evaluation of airway morphology while having the mandible gradually lengthened by mandibular distraction osteogenesis (DO). Airway changes were measured during treatment to guide therapy. These measures allowed sequential correlation of changes in both soft tissue and bone morphology.