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OSAS patients tended to have a posteriorly positioned and posteriorly rotated mandible with a higher gonial angle, a longer lower facial height, a greater mandibular plane angle, and a moderately retracted chin.
15, 16] However, none of the children with OSAS in our study had mandibular micrognathia.
The lower incisors in the children with OSAS tended to exhibit a retrocline.
In adults with OSAS, the entire structure of the cranial base has been reported to be rotated slightly counterclockwise in the sagittal plane, [15] but we did not observe a similar counterclockwise rotation in children.
In our study, the children with OSAS had a narrower epipharyngeal airway space than did the controls and a significantly larger value with regard to the height of the lower pharynx.
Altogether, this study indicates that the retromandibular space, as measured by lateral cephalography, is smaller in most children with OSAS and appears to provide insufficient space for the tongue in the pharyngeal cavity.
Most studies that have attempted to estimate OSAS mortality have been criticized for their small sample sizes, short followup, failure to control for confounding variables associated with obesity or smoking, and other shortcomings inherent in retrospective natural history studies.
Several abnormal patterns of craniofacial development have been recognized in adults who were previously considered to be morphologically normal but who manifested OSAS.
OSAS is characterized by brief interruptions in breathing during sleep lasting more than 10 seconds and as long as 60 seconds.