Craniofacial proportions in children with adenoid or adenotonsillar hypertrophy are related to disease duration and nasopharyngeal obstruction

Pawłowska-Seredyńska, Katarzyna; Umławska, Wioleta; Resler, Katarzyna; Morawska-Kochman, Monika; Pazdro-Zastawny, Katarzyna; Kręcicki, Tomasz

doi:10.1016/j.ijporl.2020.109911

Cited by 16 publications

(8 citation statements)

References 22 publications

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“…During this growth period, the adenoids start to diminish, which alleviates the effect of adenoid hypertrophy on craniofacial growth. Furthermore, changes in maxillofacial development appear as a result of long-term disease duration rather than the presence of the disease [21].…”

Section: Discussionmentioning

confidence: 99%

Age-group-specific associations between adenoid/tonsillar hypertrophy and craniofacial features

Huang,

Zheng,

Chen

et al. 2024

Preprint

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Background Age plays an important role in the association between adenotonsillar hypertrophy and craniofacial morphology. This study aimed to analyse the association of adenoid and tonsillar hypertrophy with craniofacial features in different age groups. Methods Lateral cephalograms were obtained from 942 patients aged 6–15 years (433 boys, 509 girls). They were divided into three age groups: 6–9 years (n = 189), 9–12 years (n = 383), and 12–15 years (n = 370). According to the different sites of pharyngeal obstruction, they were classified as control group (CG), adenoid hypertrophy group (AG), tonsillar hypertrophy group (TG) and adenotonsillar hypertrophy group (ATG). Cephalometric measurements were performed on each enrolled participant. Comparisons between groups and correlations between these cephalometric variables and obstruction sites were evaluated. Results At 6–9 years of age, ATG and TG correlated with increased mandibular height (B = 2.2, p = 0.029; B = 2.6, p = 0.042, respectively). At the age of 9–12 years, AG showed a steep growth direction (B = 1.5, p = 0.002), TG showed a higher probability of Class III skeletal pattern (smaller SNB, ANB and SGn/FH, larger Go-Me) and ATG manifested a higher proportion of Class III skeletal pattern. At 12–15 years of age, there was no significant association between cephalometric measurements and pharyngeal lymphoid tissue enlargement. Conclusions Children with isolated adenoid hypertrophy have a vertical growth direction at 9–12 years of age. Isolated adenoid hypertrophy correlated with longer mandibular body, more anterior mandible and horizontal skeletal Class III pattern at 6–12 years. Combination of obstructive adenoids and tonsils manifested similarly to children with isolated tonsil hypertrophy.

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Section: Discussionmentioning

confidence: 99%

Age-group-specific associations between adenoid/tonsillar hypertrophy and craniofacial features

Huang,

Zheng,

Chen

et al. 2024

Preprint

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“…Tongue would act as a stimulation factor to activate forward growth of the mandible [ 5 ]. On the contrary, adenoid hypertrophy results in downward position of the tongue and the mandible and extended head posture [ 6 , 20 ], which further leads to a retrognathic mandible and a steep mandible angle plane [ 7 , 12 , 16 ]. Another hypothesis that must be mentioned is that continuous airflow through the nasal cavity produces a constant stimulation for the lateral growth of maxilla and for the lowering of the palatal vault [ 28 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…Increased upper airway resistance related to adenotonsillar hypertrophy is the main pathogenetic abnormality in children with obstructive sleep-disordered breathing (SDB) [ 2 ]. The relationship between SDB and craniofacial morphology has been a hot topic and has been extensively studied in decades [ 3 – 16 ]. However, when analyzing the relationship between adenotonsillar hypertrophy and craniofacial morphology, previous studies generally ignored the different locations of adenoids and tonsils.…”

Section: Introductionmentioning

confidence: 99%

Age-related hypertrophy of adenoid and tonsil with its relationship with craniofacial morphology

Huang

Gao

2023

BMC Pediatr

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Background When analyzing the relationship between adenotonsillar hypertrophy and craniofacial morphology, researchers generally regarded hypertrophied adenoids and tonsils as a whole. It remains unclear whether different enlarged sites of pharyngeal lymphoid tissue would correlate with multiple craniofacial subtypes. We hypothesized there would be craniofacial subtypes correlated with different locations of hypertrophied adenoid and tonsil. Methods Lateral cephalometric radiographs were obtained from 466 children (171 boys and 295 girls, aged 12.27 ± 2.69 years). They were divided into four groups according to different sites of enlarged pharyngeal lymphoid tissue: adenoid hypertrophy group (AG, n = 126), tonsillar hypertrophy group (TG, n = 59), adenotonsillar hypertrophy group (ATG, n = 69) and control group (CG, n = 212). Five commonly used angles for cephalometric measurements were investigated: SNA (Sella-Nasion-Point A), SNB (Sella-Nasion-Point B), ANB (Point A-Nasion-Point B), mandibular plane angle (MP/SN) and Y-axis angle (SGn/FH). Results Children with isolated tonsillar hypertrophy correlated with increased SNA (unstandardized regression coefficient B = 1.38, p = 0.009) and SNB (B = 1.99, p = 0.001) compared with controls. However, children with isolated adenoid hypertrophy correlated with decreased SNB (B=-0.94, p = 0.036), increased ANB (B = 0.74, p = 0.014) and increased MP/SN (B = 2.22, p < 0.001). Similarly, children with adenotonsillar hypertrophy correlated with decreased SNB (B=-1.36, p = 0.015), increased ANB (B = 1.35, p < 0.001) and increased MP/SN (B = 2.64, p = 0.001). Conclusions Isolated adenoid hypertrophy correlated with a retrognathic mandible, an increased maxillo-mandibular sagittal discrepancy, and an increased mandibular plane angle. Isolated tonsillar hypertrophy correlated with maxillary and mandibular protrusion. Adenotonsillar hypertrophy did not show a superimposed craniofacial pattern of the above two but showed the same craniofacial pattern as isolated adenoid hypertrophy.

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“…Although adenotonsillar hypertrophy is considered the most common etiology for OSA in the pediatric population, studies in premature infants support the hypothesis that tonsillar hypertrophy occurs because of mouth breathing due to abnormal craniofacial features documented as a high arched, narrow, hard palate [26 ▪ ,27 ▪ ]. Duration of nasopharyngeal obstruction in the pediatric population is a strong predictor of vertical facial dysplasia (long face syndrome) [28]. Understanding the background and etiologic factors contributing to pediatric OSA, particularly the impact of high arched, narrow, hard palate, is crucial for diagnosing and treating this condition effectively, at least in a subset of patients.…”

Section: Introductionmentioning

confidence: 99%

Something to consider: rapid palatal expansion for treatment of obstructive sleep apnea in pediatric patients

Ahsan,

Narala,

Ednick

et al. 2023

Current Opinion in Pediatrics

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Purpose of review This review examines the potential of rapid palatal expansion (RPE) as a treatment for pediatric obstructive sleep apnea (OSA). The focus is on recent findings related to its efficacy, safety, patient selection, timing, appliance options, cost considerations, and long-term outcomes. Recent findings Recent studies indicate that RPE can lead to significant improvements in pediatric OSA, with a 70% reduction in the Apnea Hypopnea Index (AHI) and increased oxygen saturation levels. It has been particularly effective in children with small or absent tonsils and has been found to reduce adenoid and tonsil size. Long-term follow-up studies suggest the need for ongoing monitoring, as some patients may experience relapse over time. Summary RPE shows promise as an additional treatment for pediatric obstructive sleep apnea. It offers improvements in respiratory function and reduced symptoms in certain patients. However, long-term efficacy and safety require further investigation. Comparative studies and patient-reported outcomes are necessary to optimize treatment approaches. Collaboration between orthodontists, sleep specialists, and ear-nose-throat (ENT) specialists may be essential for optimal outcomes in pediatric OSA patients treated with RPE.

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Craniofacial proportions in children with adenoid or adenotonsillar hypertrophy are related to disease duration and nasopharyngeal obstruction

Cited by 16 publications

References 22 publications

Age-group-specific associations between adenoid/tonsillar hypertrophy and craniofacial features

Age-group-specific associations between adenoid/tonsillar hypertrophy and craniofacial features

Age-related hypertrophy of adenoid and tonsil with its relationship with craniofacial morphology

Something to consider: rapid palatal expansion for treatment of obstructive sleep apnea in pediatric patients

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