Lateral Ceph -- how big are my airways?

[tjarrr]

Hi all, I had a lateral ceph done which I posted about a few months back in the aesthetics subforum. My question now is basically functional -- is anyone able to tell the size of my airways by looking at my lateral ceph? I can't really tell myself because my jaw makes the area somewhat opaque and I can't tell where the airway starts or ends.

http://imgur.com/a/vpQta

Basically I'm a skeletal class III case with a normal SNB angle and a smaller SNA angle by 4-5 degrees, and a normal mandibular plane angle. My dentition is completely normal except for a measurement called "U6 - PT Vertical" (I don't know what it means and online research has not been fruitful), the value for which was 7.1 mm whereas a normal value is 18 mm. Does anyone know what this means?  Although my SNB angle is normal and my lower jaw is not recessed, some nights I feel I don't sleep well and I wake up in the morning not feeling well rested. It's possible my recessed maxilla could be contributing by creating some nasal airway resistance or by not giving enough room for my tongue causing it to slip back during sleep. Or, I could just have constricted airways independent of either upper or lower jaw issues.

I had a sleep study done and it was normal and showed no apneas, however, I don't know how reliable it is because I didn't sleep very well at the lab and probably didn't have much time in REM sleep anyway. I'll have to re-check the specifics.

I should note that I did have 1.5 glass of wine right before I went to bed and that may very well have caused the sleep apnea or made it worse. What are people's thoughts?

[slysurfz]

Based on the Ceph it seems you have a large enough airway. A cone beam CT will give a better idea on your airway size.
However, if your sleep study  did not show any apneas thats a good sign that you dont have sleep issues.

Do you have allergies? deviated septum etc? it doesn't seem you have any OSA however sleep apnea can also be central which is a nervous system issue and cant be fixed with surgery etc.

If you share your sleep study report here or via PM I can take a look. Also, nobody sleeps well on a sleep study but it does give you decently accurate results

[tjarrr]

I had a cone beam CT done at the same time as the lateral ceph and I'll see if the office can send me some copies of it. I don't have allergies and I had a septoplasty done a few years ago with nasal polyp removal + turbinate reduction. My nose looks worse but functionally I do breathe much better than before. I have a tendency to fall back on mouth breathing sometimes though, I think maybe it's because my maxilla is recessed and that causes more nasal airway resistance regardless?

(Interestingly, I was a chronic mouth breather in childhood because of my deviated septum but I don't have long face syndrome and my mandibular plane + gonial angles, dentition, SNA + SNB etc are all normal. I don't know what that says about the mouth breathing --> bad facial aesthetics/long face theory. I feel that the counter theory that it's the other way around (ie long faces cause mouth breathing, presumably by creating too much nasal airway resistance) is more plausible.)

[Wheatsnax]

i dont think you posture your head when you sleep like this so its not an accurate representation

i had to redo all my previous cephs and 3d planning scans due to posture