Secondary analysis of airway obstruction in children with adenoid hypertrophy: Association with jaw size and position

Abstract

Rising information on the potential of the environment to influence phenotypical expression invited revisiting prior data on the effect of airway obstruction on jaw size, not only position. AimEvaluate the jaw interactions in response to graded airway obstruction and their effect on jaw size. Methods200 consecutively examined mouth-breathing children (age: 6.00 ± 2.62years) were referred by the pediatric otorhinolaryngologist for lateral cephalometric assessment of adenoid hypertrophy. Cephalometric measurements included maxillary and mandibular lengths, inclinations of palatal and mandibular planes and as airway measurement, the shortest distance from soft palate to adenoid (AD). Three severity groups were categorized on airway clearance level: AD1: >6mm, AD2: 2-6 mm, AD3: ≤2mm. All parameters were compared among the groups and to control databases. Statistics included one-way analysis of variance for group differences, linear and multiple regressions for associations and prediction models. ResultsAge was statistically significantly different (p < 0.001) among groups (AD1: 7.72 ± 3.02years; AD2: 5.89 ± 2.42years; AD3: 5.13 ± 2.21years). Cephalometric measurements in AD1 and AD2 were closest to normative data over time; the most severe AD3 diverged from these data. Variation in AD was accounted for by the combination of age and either mandibular length Co-Gn (59.4%) or maxillary length ANS-PNS (43.4%). Predictors of Co-Gn included the combination of ANS-PNS and AD (64.8%), and that of age, AD and palatal plane cant (62.4%). ConclusionThe results suggest that reduced nasopharyngeal clearance affects maxillary and mandibular size, the latter directly influenced by the maxillary changes.