Improvement in respiration and craniofacial changes associated with weight loss after bariatric surgery

To study weight loss, craniofacial changes, and respiratory quality among obese patients before and after bariatric surgery.

The obese group comprised 17 male and female patients aged between 18 and 60 years with body mass index (BMI) ≥ 40 kg/m(2) who were scheduled to undergo bariatric surgery. All patients were evaluated in the preoperative period and at least 4 months following surgery by means of clinical, physical, anthropometric, facial, nasal, oral, and oropharyngeal examinations as well as radiographic examinations of the facial profile with individual cephalometric analysis. Patients also completed the Nasal Obstruction Symptom Evaluation scale. The control group underwent the same examinations and included 10 male and female volunteers with BMI between 18 and 30 kg/m(2), good dental occlusion, harmonious facial features, and no history of respiratory or sleep disorders.

There were significant reductions in weight, BMI, and neck circumference as well as an improvement in Nasal Obstruction Symptom Evaluation scores in the obese group after bariatric surgery (P < .05). There was a reduction in craniocervical length, increase in velopharyngeal air space, and reduction in the distance between the hyoid bone and mentum following weight loss. The Mallampati Scale revealed a significant inversion of palate position categories between evaluations.

There was improvement in respiratory quality and craniofacial changes caused by weight loss, especially in soft tissues around the upper air space, as well as craniocervical length and position of the hyoid bone.