The purpose of this study was to compare two groups of adult men from diffe
rent ethnic backgrounds and with obstructive sleep apnea; they were selecte
d by matching age, gender, skeletal pattern, body mass index, and respirato
ry disturbance index. Pretreatment cephalometric radiographs and overnight
polysomnograms of 30 Chinese and 43 Caucasian patients with Class II, Divis
ion 1 malocclusions were analyzed to investigate if there were craniofacial
and upper airway structural differences between the two ethnic groups. The
Chinese group, when compared with the group of Caucasian patients, reveale
d more severe underlying craniofacial skeletal discrepancies with significa
ntly smaller maxilla and mandibles, more severe mandibular retrognathism, p
roclined lower incisors, increased total and upper facial heights, and stee
per and shorter anterior cranial bases. However, no significant differences
were found between the two groups in posterior facial height, ratio of upp
er to lower anterior facial height, and the position of hyoid bone, maxilla
, and upper incisors. With regard to soft tissue and upper airway measureme
nts, there were no significant ethnic differences in tongue and soft palate
size, vertical length of oropharynx, and anteroposterior dimensions of the
upper airway at most of the levels except for a larger super-posterior air
way space, a larger nasopharynx and oropharynx cross-sectional area, and a
smaller tongue height in the Chinese group. We conclude that there are a nu
mber of craniofacial and upper airway structures that differ between the tw
o ethnic groups that may be relevant to the treatment of obstructive sleep
apnea in various ethnic groups.