Objective: The purpose of this study is to compare the cephalometric differences between males and females with obstructive sleep apnea undergoing maxillomandibular advancement (MMA).
Materials and Methods: Measurements of lateral cephalometric radiographs obtained from 91 OSA patients (20 females) were compared between males and females. Demographics including age, Apnea-hypopnea index and BMI were collected. Twenty pairs of cephalometric measurements, before and within one month after surgery, were taken using picture archiving and communication system (PACS). Statistical differences of intra- and intergroup were assessed by paired and independent t tests (P <0 .05), respectively.
Results: The average age at surgery was 31.2 (18~59) years in females and 34 (18~62) years in male. BMI was 20.7±3.6 kg/m2 in females and 23.9±3.3 kg/m2 in males. Before surgery, the AHI were 34±31.4 and 45.2±29.1 of female and male patients respectively. After surgery, the AHI dropped to 5.7±6.3 and 9.1±8.9 in females and males. The successful rate of surgery were 94% for female and 90% for male. There was no cephalometric difference between OSA males and females before the operation. After the MMA surgery, significant improvements were found in cephalomatric parameters of both genders. When comparing the postoperative structural differences between male and female, male OSA patients present longer pharyngeal airway length, and lower tongue position, which could be the predictor for worse polysomnographic outcomes.
Conclusions: Significant cephalometric deffierence between gender after MMA surgery could be a prdictor for the better polysomnographic outcome in females. Further modification of MMA in male is recommended.

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