Fig. 6

Patient 3’s oropharyngeal anatomy before and after her maxillofacial surgery to replace her temporomandibular joints and relieve her obstructive sleep apnea. Preoperatively, the patient’s degenerating mandibular condyles can be seen disarticulated from the glenoid fossa of the temporal bone, circled with a fine white line in the lateral boney view. Consequently, the mandibular body (and the chin, in the lateral soft tissue view) has receded, and the airway is markedly narrowed. The surgical procedure included an arthroplasty, a LeFort 1 osteotomy, and an anterior inferior mandibular osteotomy (genioplasty; see also Fig. 5). The custom-made condylar prostheses served both to articulate with the glenoid fossa and to advance the mandibular body, making a bilateral sagittal split ramus osteotomy unnecessary (see Fig. 3 legend). The lateral and frontal boney views show the hardware implanted during the surgery and the braces applied by the orthodontist. The postoperative soft-tissue view shows the elongation of the jaw line and the widened pharyngeal airway