Serial cephalometric studies on 29 patients with Apert syndrome and 26 patients with Crouzon disease confirmed and expanded previously reported observations of dysmor— phology of the nasopharynx and contiguous structures. Particularly remarkable were alterations in pharyngeal depth, pharyngeal height, length of the posterior cranial base, and length of the hard and soft palate. The distortions and displacements contributing to diminition of the nasopharyngeal space were typically present early in life and became more severe as the patient matured. Implications for care and treatment planning are discussed.