Persistent Craniofacial and Airway Alterations in Young Adults with Isolated Robin Sequence: A CBCT- Based Analysis

Objectives: To assess craniofacial and upper airway morphological characteristics in young adults with isolated Robin sequence (IRS) using cone-beam computed tomography (CBCT), compared with matched controls. Materials and Methods: This cross-sectional study included CBCT scans from 12 individuals: six with IRS and six controls matched by sex and craniofacial skeletal pattern. Morphometric analyses of the tongue, oral cavity, mandible, hyoid bone, and oropharyngeal airway were performed using two- and three-dimensional computational approaches. Group comparisons were conducted using Student’s t-test, and effect sizes were calculated using Cohen’s d . Results: Individuals with IRS exhibited significantly reduced tongue area, tongue length, oral cavity area, and oropharyngeal airway depth compared with controls (p ≤ 0.05), with large effect sizes (d ≥ 1.7). Mandibular body length, total length, and mandibular angle were also significantly reduced. Hyoid bone volume and positional parameters differed significantly between groups. Several variables demonstrated moderate to large effect sizes despite non-significant p-values. Conclusions: Craniofacial and airway-related morphological alterations appear to persist into adulthood in individuals with IRS and may contribute to impaired aerodigestive function. Clinical Relevance: These findings highlight the importance of long-term structural assessment in individuals with IRS, particularly regarding potential airway compromise and associated functional outcomes.