We studied 15 children ofpreschool age who had obst ructive sleep apnea syndrom e to evaluate thei r dentof acial morph ology in relation to the pharyngeal airway spac e. We fo und that (1) sleep apnea was often associated with mandibular retrognathia , (2) the lower incisors tended to exhibit a retroclin e, (3) there were no signific ant differences in angular and linear measurements in the cranial base between pat ients with sleep apnea and a control group of30 nonapn eic children, and (4) the apn eic children had a narrower epipharynge al airwa y space than did the controls. These findin gs suggest that obstructive sleep apn ea is probably caused by both adenoidal hypertrophy and abnormal developm ent ofthe f acial skeleton. We highly recomm end cephalometric analysis as a valuable tool fo r conducting the presurgical evaluation of sleep apnea in children ofpreschool age.

The findings show that children with SBDT display a characteristic facial appearance at an early age. Since the condition has an effect on growth, it needs to be prevented by controlling morphology and function at the preschool age.

Rönning O. Craniofacial morphology in preschool children with sleep-related breathing disorder and hypertrophy of tonsils. Acta Paediatr 2002; 91: 71-77. Stockholm. ISSN 0803-5253The purpose of this study was to examine craniofacial morphology, pharyngeal airway space and hyoid bone position in preschool children with sleep-related breathing disorder associated with hypertrophy of tonsils (SBDT). Thirty-eight preschool children, mean age 4.7 y, with SBDT and with an apnoea index (AI) of 0 < AI <5, were divided into two groups. One consisted of 15 children with sleep-related breathing disorder (SBD) and more than 75% of the tonsils visible (GIII) and the other of 23 children with SBD and 25-75% of the tonsils visible (GII). The control group consisted of 31 children without ear, nose and throat disease and with GI (barely visible) tonsils. Compared with the controls, GIII children had a retrognathic mandible, a large posterior facial height, a large interincisal angle with retroclined lower incisors, a narrow pharyngeal airway space, an anterior tongue base position and a long soft palate. Compared with the controls, GII children had a large anterior lower facial height and a short nasal oor. However, like the controls, GII children did not have a retrognathic mandible. Conclusion:The ndings show that children with SBDT display a characteristic facial appearance at an early age. Since the condition has an effect on growth, it needs to be prevented by controlling morphology and function at the preschool age.

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