The present investigation studied changes of hyoid bone position and pharyngeal depth at the levels of the second and fourth cervical vertebrae and their relationships in mandibular prognathism patients who received combined orthodontic-surgical treatment. The material consisted of presurgical and 1-year postsurgical profile cephalograms of 52 adult orthognathic surgery patients (40 females and 12 males) who initially had mandibular prognathism and had undergone bilateral vertical ramus osteotomy through an extraoral incision in the retroangular area. Hyoid bone position and pharyngeal depth were assessed on the profile radiographs with 10 cephalometric variables. Paired t tests were used to evaluate the operative changes in all cephalometric parameters. The relationships between pairs of variables describing hyoid bone position and pharyngeal depth were assessed by means of Pearson's product-moment correlation analysis. Significant differences ( p < 0.01) were observed for the distances of the hyoid bone to the maxilla and the mandible. The distances of the hyoid bone with the anterior cranial base, the vertebral column, and the anterior pharyngeal wall, and the measurements representing pharyngeal depth exhibited no significant changes ( p > 0.05). Moderate correlations were seen between (1) the depth of the pharynx at the fourth cervical vertebra and the hyosymphyseal distance ( r = 0.34) and the distance between the point of the projection of the hyoid bone to the mandibular line with its posterior border ( r = −0.34), and (2) the depth of the pharynx at the second cervical vertebra and the distance of the hyoid bone with the anterior pharyngeal wall at the level of the fourth cervical vertebra ( r = −0.33). The hypothesis that the posterior surgical mandibular repositioning may reduce the airway at the levels of the second and fourth cervical vertebrae cannot be supported by the findings of the present investigation. In addition, it is indicated that a reflex alteration in the pharyngeal muscular mechanism and the biomechanical conditions of the supra- and infrahyoid muscles takes place postoperatively.