Facial Growth Research Articles

Comparison of Facial Growth Between Two Nasoalveolar Molding Techniques in Unilateral Complete Cleft Lip Patients: A Randomized, Prospective, Single-blind Trial.

Nasoalveolar molding (NAM) has become standard treatment in our Craniofacial Center. Two types of pre-surgical NAM, Grayson technique and Figueroa technique, co-exist. We previously found no differences in number of clinic visits, cost and 6 months post-operative outcome between the two techniques. Since Figueroa's method involves passive, whilst Grayson's method involves active, alveolar molding, we extended the previous study to evaluate facial growth between these two groups. This randomized, prospective, single-blind study, conducted between May 2010 and March 2013, recruited 30 patients with unilateral complete cleft lip and palate patients and randomized them for Grayson or Figueroa pre-surgical NAM. Their standard lateral cephalometric measurements at 5 years were used to determine facial growth. Twenty-nine patients completed 5 years of follow-up. There were no statistical differences in facial cephalometric measurements between the two groups. Pre-surgical NAM using either passive or active NAM technique produced similar facial growth patterns after unilateral cleft lip and palate repair.

In Utero Exposure to Maternal Electronic Nicotine Delivery System use Demonstrate Alterations to Craniofacial Development.

Develop a model for the study of Electronic Nicotine Device (ENDS) exposure on craniofacial development. Experimental preclinical design followed as pregnant murine dams were randomized and exposed to filtered air exposure, carrier exposure consisting of 50% volume of propylene glycol and vegetable glycine (ENDS Carrier) respectively, or carrier exposure with 20 mg/ml of nicotine added to the liquid vaporizer (ENDS carrier with nicotine). Preclinical murine model exposure using the SciReq exposure system. C57BL6 adult 8 week old female pregnant mice and exposed in utero litters. Exposure to control filtered air, ENDS carrier or ENDS carrier with nicotine added throughout gestation at 1 puff/minute, 4 h/day, five days a week. Cephalometric measures of post-natal day 15 pups born as exposed litters. Data suggests alterations to several facial morphology parameters in the developing offspring, suggesting electronic nicotine device systems may alter facial growth if used during pregnancy. Future research should concentrate on varied formulations and exposure regimens of ENDS to determine timing windows of exposures and ENDS formulations that may be harmful to craniofacial development.

Growth patterns of the nasolabial region following unilateral cleft lip primary repair.

Surgical correction is the optimal way of repairing a congenital cleft lip. Patients with this condition often undergo initial surgical treatment at an early age and achieve an acceptable outcome. However, their levels of satisfaction will decrease in later stages of life as facial growth and development will inevitably cause changes in long-term outcomes, especially in the nasolabial region. Therefore, it is important for surgeons to understand nasolabial development after primary treatment and tailor their surgical techniques appropriately. This review focuses on the growth patterns of the nasolabial region after primary repair, so as to provide references for operative strategy.

Paediatric condylar trauma- primary management considerations - A review.

Children are not simply ''small adults'', and the application of adult-type treatment can be inappropriate in many circumstances. Their craniomaxillofacial (CMF) structure changes dramatically as children grow and develop. This anatomical change also changes the location, pattern, and nature of CMF injury. Similarly, condylar architecture and anatomy also differ in children, due to which the management of paediatric condylar fractures is strikingly different from adult condylar fractures. In addition to this physiological, and behavioural differences pose an additional challenge to a surgeon. Paediatric condylar fracture also considers conservative/non-operative treatment as an effective treatment option. However, the decision between operative and non-operative management compromises paediatric facial growth, precise reduction, and rigid fixation. This decision is crucial and is guided by many factors. Improper treatment protocol can have a devastating effect on a child facial growth and development. It can lead to various deforming complications mainly ankylosis. Hence treatment of paediatric condylar fracture should be well planned and executed.

Functional cleft palate surgery.

Cleft lip and palate (CLP) as a dislocation malformation confronts parents with a malformation of their child that could not be more central and visible: the face. In addition to the stigmatizing appearance, however, in cases of a CLP, food intake, physiological breathing, speech and hearing are also affected. In this paper, the principles of morphofunctional surgical reconstruction of the cleft palate are presented. With the closure of the palate, and restoration of the anatomy, a situation is achieved enabling nasal respiration, normal or near normal speech without nasality, improved ventilation of the middle ear, normal oral functions with coordinated interaction of the tongue with the hard and soft palate important for the oral and pharyngeal phases of feeding. With the establishment of physiological function, in the early phases of the infant and toddler, these activities initiate essential growth stimulation, leading to normalisation of facial and cranial growth. If these functional considerations are disregarded during primary closure, lifelong impairment of one or more of the abovementioned processes often follows. In many cases, despite secondary surgery and revision, it might not be possible to correct and achieve the best possible outcomes, especially if critical stages of development and growth have been missed or there has been significant tissue loss due to resection of existing tissue while primary surgery. This paper describes functional surgical methods and reviews long term, over many decades, results of children with cleft palate.

The influence of obstructive sleep apnea syndrome on orthodontic treatment decisions in children and adolescents. Part 1: OSA phenotypes, treatment temporality and reciprocal effects on growth

Pediatric OSAS is a complex condition, comprising a plurality of clinical signs, complicated by the phenomena of growth. Its etiology is dominated by the hypertrophy of lymphoid organs, but obesity and certain craniofacial and neuromuscular tone abnormalities also contribute. The authors summarize the interrelations between pediatric OSAS endotypes, phenotypes and orthodontic anomalies. They report clinical practice recommendations on the multidisciplinary management of pediatric OSAS and define the place and timing of orthodontics. There is an indication for treatment of pediatric OSAS for an OAHI greater than 5/h, regardless of comorbidity, as well as for symptomatic children, whose OAHI is between 1-5/h. The first line of treatment is adenotonsillectomy, but it does not always normalize the OAHI. Complementary treatments are often necessary: early orthodontics (rapid maxillary expansion, myofunctional appliances), oral reeducation, as well as the management of obesity and allergies. Careful watching, without treatment is possible for mild cases with few symptoms, as pediatric OSAS tends to resolve naturally with growth. The therapeutic approach is stratified, depending on the severity of OSAS and the child's age. In terms of orthodontic repercussions, obesity is associated with earlier maturation and some facial morphological differences, while oral hypotonia and nasal obstruction can alter facial growth, promoting mandibular hyperdivergence and maxillary deficiency. Orthodontists are in a privileged position for the detection, follow-up and certain treatments of OSAS.

Turbinate surgery in pediatric patients: A worldwide survey

ObjectiveImpaired nasal breathing is a common condition among pediatric patients, being rhinitis the most common cause. In recent years, turbinate surgery, mainly turbinate radiofrequency ablation (TRA), has increased in popularity amongst pediatric otolaryngologists and rhinologists as a safe and useful technique to address turbinate hypertrophy in pediatric patients. The present paper is designed with the aim of assessing the current worldwide clinical practice regarding turbinate surgery in pediatric patients. MethodsThe questionnaire was developed based on previous researches, by a group of 12 experts from the rhinology and pediatric otolaryngology research group belonging to the Young Otolaryngologists of the International Federation of Otorhinolaryngological societies (YO-IFOS). The survey was then translated to 7 languages and sent to 25 scientific otolaryngologic societies around the globe. Results15 scientific societies agreed to distribute the survey to their members. There were 678 responses from 51 countries. From them, 65% reported to usually perform turbinate surgery in pediatric patients. There was a statistically significant increased likelihood of performing turbinate surgery for those practicing rhinology, sleep medicine, and/or pediatric otolaryngology compared to other subspecialties. The main indication to perform turbinate surgery was nasal obstruction (93.20%); followed by sleep disordered breathing (53.28%), chronic rhinosinusitis (28.70%) and facial growth alterations (22.30%). ConclusionsThere is no general consensus on the indications and ideal technique for turbinate reduction in children. This dissension arises mainly from the lack of scientific evidence. The points with highest agreement (>75%) between respondents is the use of nasal steroids prior to surgery; reintroducing nasal steroids in allergic patients; and performing turbinate surgery as day-case surgery.

Can Undergraduate Artists With No Training in Forensic Art Produce Accurate Age Progressions?

When children go missing and remain missing for long periods of time, authorities sometimes retain forensic artists to age progress the last known picture to provide an estimate of the current appearance. In the present research, undergraduate artists with no training in forensic art were asked to age progress images of children to an adult appearance. Similarity of age progressions produced by undergraduate artists were as similar to the corresponding targets as were age progressions produced by practicing forensic artists. However, age progressions produced by undergraduate artists were rated as being more similar to description matched foils than were the age progressions produced by professional forensic artists, suggesting that professionally produced age progressions might be more useful. Results suggest that untrained individual have sufficient knowledge of facial growth to produce age progressions that are somewhat similar to their corresponding targets.

Influence of Lip Revision Surgery on Facial Growth in Patients With A Cleft Lip.

Although patients with cleft lip and palate often present with poor maxillary growth because of intrinsic and iatrogenic factors, the surgical influence of lip revision surgery, palatal fistula repair, and pharyngeal flap procedures remains uncertain in contrast to that of primary cleft lip repair and palatoplasty. Therefore, this study aimed to reveal factors inhibiting maxillary growth and inducing later orthognathic surgery. A retrospective analysis was conducted on the data of patients with cleft lip and palate who underwent a series of treatments at Keio University Hospital from 1990 to 2000. We collected data on patient sex, cleft type, number and timing of lip revision surgery, the incidence of palatal fistulae, history of pharyngeal flap procedures, and timing of a repeat bone graft, and reviewed whether these patients underwent orthognathic surgery later in life. Multivariate analysis was conducted using binary logistic regression to extract factors affecting later orthognathic surgery. A total of 52 patients were included in this study. Results showed that revision surgery conducted more than twice was the highest statistically significant predictor of later orthognathic surgery in patients with a cleft lip and palate ( P <0.05, odds ratio=43.3), followed by palatal fistula occurrence after cleft palate repair ( P <0.05, odds ratio=22.3). Therefore, primary surgical procedure is most important for these patients.

Septorhinoplasty in an Asian-Caucasian pediatric patient with neglected nasal deviation from previous traumatic injury: a case report

Background: Numerous studies present evidence of the association between nasal-septal deviation and impaired breathing that led to a multisystem disorder, nasal-midface growth alteration, and gets worse with facial growth. However, the extent of the traumatic septal injury is often neglected. Here, we summarized the clinical experience in treating a pediatric patient with those problems. Case Presentation: A case of a 10-year-old girl with type C-IIB nasal deviation and type IVb septal deviation with left obstructive nasal breathing and snoring is presented. A nasal injury history at the age of four was reported. She had divergent dorsal lines, hump irregularity, lower lateral cartilage (LLC), columella/septum deviation, drooping-indented-boarded tip, asymmetrical nostrils, and internal valve incompetence. We conducted corrections on nasal bones by bilateral osteotomies, c-shaped anteroposterior caudal septum by scorings, mattress suture techniques and batten grafts, upper lateral cartilage by dorsal septal manipulation, tip/columella by LLC manipulation, dorsal long spreader graft, columellar strut grafts, and septum repositions. A crushed cartilage was placed on the hump. Improvements, complications, and patient satisfaction were documented. No complications were reported after the surgery. The patient was satisfied with the final result. Snoring and left nostril breathing obstructions no longer existed. Corrections on dorsal, columella and septal deviation, hump, nasal tip shape and projection, and asymmetrical nostril were observed. Conclusion: Septorhinoplasty's philosophy on pediatric patients highlighted the importance of weighing its risks. Findings suggest studies of the pediatric anatomy and surgical technique to minimize the risks. Thorough observation is also advised until the cessation of facial growth.

Evaluation of Glenoid Fossa Morphology in Different Facial Growth Patterns: A Cone Beam Computed Tomography Study

Purpose: The aim of current study was to assess the glenoid fossa morphology among different vertical skeletal patterns using cone beam computed tomography (CBCT).Materials and Methods: The CBCT images of 63 patients with Class I sagittal skeletal pattern were classified into three groups based on posterior facial height (PFH)/ Anterior facial height (AFH) ratio. Each group divided in to normal, horizontal and vertical growth pattern groups. Depth, width and inclination of glenoid fossa were measured and assessed on CBCT images. One-way analysis of variance (ANOVA) and Tukey post-hoc test were used to compare mean values of measured variables among the groups.Results: The width (28.76±0.79) and depth (14.61±0.514) of glenoid fossa were lower in horizontal in comparison to vertical and normal growth patterns (p-value&lt;0.05). Although steepness of glenoid fossa was higher in normal growth pattern (123.8±16.68), no statistically significant differences were seen (p-value: 0.819).Conclusion: The width and depth of glenoid fossa were significantly lower in horizontal growth pattern.

Comparison of the posterior teeth angulations in orthodontic patients with different facial growth patterns.

Dental relationships can be affected according to the pattern of facial growth. Thus, the aim of this study was to compare the angulations of posterior teeth in patients with different patterns of facial growth. A total of 412 lateral head radiographs were included. The facial skeletal growth pattern was evaluated with the Björk-Jarabak analysis. For the angular measurements of the posterior teeth, the apex-cusp inclination of the premolars and the long axes of the molars were considered, with respect to the occlusal, palatal and mandibular plane. The intraclass correlation coefficient (ICC) was used to evaluate the intra-examiner concordance. One way ANOVA was used to compare the values between the patterns of facial growth. A significance level was set at 0.05. A high intra-examiner correlation was observed (0.75). Subjects with horizontal and normal growth presented significantly different angulations for the first and second premolars in relation to the palatal plane than the vertical growth (p<0.05). Subjects with horizontal growth pattern showed greater angulation of the teeth with respect to the occlusal plane than the other groups (p<0.05). The angulations of all mandibular teeth related to the mandibular plane were significantly higher for the group with horizontal growth (p<0.05). The first and second premolars presented greater angulations in subjects with horizontal and normal growth than in those with vertical growth. The angulations of all mandibular teeth were significantly higher in the horizontal growth according to the mandibular plane. Key words:Facial growth pattern, posterior tooth, occlusal plane, palatal plane, mandibular plane.

Breastfeeding Effect on Primary Teeth Emergence in Relation to Craniofacial Growth among Iraqi Infants

Background: Breastfeeding is more than just nutrition; it can be viewed as a natural orthotic device for the harmonious development of the face. Sucking has an impact on a child’s premaxillary region’s growth, and mandibular movements encourage mandibular growth. Along with the advantages for general health, breastfeeding also helps with the right development of teeth, face muscles, and occlusion. Hence symmetric, well-proportioned face and appropriate occlusion depend on balanced facial growth. Objectives: This study aims to evaluate the effect of breastfeeding on the timing of teething in relation to craniofacial development. Materials and Methods: This study is a cross sectional comparative study concerning craniofacial growth assessment, with prospective view concerning timing of eruption. Sample was composed of 100 breastfed infants compared with 100 infants depending on formula milk. Clinical examinations and follow-up for teeth emergence was done for whole sample. Results: Breastfeeding was found to be associated with early teeth emergence. Additionally, although, there were no significant differences between facial growth and feeding pattern there was a significant correlation between delay eruption time of primary dentition and facial growth parameters (mandible and maxilla depths) among bottle-feeding group. Conclusion: The current study confirms the effect of breastfeeding on the early teething emergence of primary dentition; however, there were no significant differences between type of feeding and facial growth parameters. While a significant relation between delay eruption time and facial growth parameters (mandible and maxilla depths) was found among bottle-feeding infants.

Knowledge and Attitudes of Parents Regarding Digit Sucking Habit in Children in Pune: A Questionnaire-based Cross-Sectional Study

Introduction: Digit sucking is a most common oral fixation observed in children, which involves placement of thumb or fingers into the mouth. Knowledge of the risk factors for the presence of this habit helps to provide a better understanding of the phenomena and is of great significance to the establishment of preventive measures, which can avoid the damage caused by the persistence of these habits. Aim: To evaluate the knowledge and attitude of parents of children aged between 3-6 years regarding digit sucking habit. Materials and Methods: A cross-sectional study was carried out in the Department of Paediatric and Preventive Dentistry, belonging to urban and semiurban area of Pune, Maharashtra, India from December 2020 to May 2021. A total of 310 parents of children, aged between 3-6 years were included. A closeended questionnaire was administered to parents to assess their knowledge and attitude regarding digit sucking habit in children. Completely filled questionnaires were considered for result synthesis. The data obtained was tabulated and descriptive data were statistically analysed using software International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) version 21.0. Results: Although 229 (73.9%) of parents agreed that for achieving good oral health prevention of digit sucking habit is essential, but 197 (63.5%) parents were unaware of the predisposing factors for digit sucking habit. A total of 195 (62.9%) parents did not agree that inadequate parental attention may lead to thumb sucking habit. A total of 197 (63.5%) parents agreed that prolonged digit sucking can cause misaligned teeth but majority of the parents 205 (66.1%) and 166 (53.5%) disagreed on its effects on facial growth and speech respectively. A total of 219 (70.6%) parents did not receive any scientific information or counselling from healthcare worker regarding sucking habit. A total of 299 (96.5%) of parents agreed that guidance from healthcare workers is needed regarding oral habits in children. Conclusion: Present study concluded that the attitude towards learning about digit sucking habit was good the knowledge of the study participants was poor.

Orthodontic considerations for patients presenting with Goldenhar Syndrome: A long-term case report

Abstract Introduction The correction of facial asymmetry in patients presenting with Goldenhar Syndrome can be challenging due to the complexity of the orthodontic and surgical procedures required, the psychosocial considerations of the patient and the risk of relapse. Materials and methods A Caucasian male with Goldenhar Syndrome originally presented at age 8.2 years with concerns relating to a poor bite. He had previously undertaken surgery for the removal of pre-auricular skin tags on the right side. With ongoing skeletal growth, the facial asymmetry became more obvious and caused the patient to become socially withdrawn. Multidisciplinary treatment involving orthodontics and orthognathic surgery to correct the mandibular asymmetry was delayed until facial growth had slowed. The correction involved the use of an asymmetrical bilateral sagittal split osteotomy and an advancement genioplasty followed by a dermal fat graft and MedporR onlay to the right mandibular body and angle in addition to a refinement genioplasty. Results Follow-up has revealed a partial return of a buccal openbite illustrating the risk of occlusal relapse. Conclusion The case report illustrates the complexity of the orthodontic and surgical management of facial asymmetry, the psychosocial considerations of the patient and the risk of relapse. Multidisciplinary management is essential in the management of Goldenhar Syndrome.

Assessing the Effectiveness of Chin-Cup Therapy in the Treatment of Developing Class 3 Malocclusions

Background: Mandibular prognathism in Class 3 malocclusion (CLIII) is one of the most severe maxillofacial deformities. Fortunately, most of this malocclusion cases can be treated by facial growth modification, using extra and/or intra-oral appliances in growing individuals. Occipital-pull chin cup is the extra-oral orthopaedic appliance, which was mostly used for the treatment of mandibular prognathism in growing Class 3 1(Ngan, Sung, 2015). Unjustifiably, most orthodontists I know do not use chin cup therapy in the treatment of CLIII. Therefore, being new to the field of orthodontics, I needed to build a highly evidenced based knowledge on chin cup therapy’s effectiveness in the treatment of developing CLIII with prognathic mandible. Objective: Through a narrative literature review, the aim of the study was assessed following scientific methodology. Articles published from January 2010- November 2020 (commencement of the current review) were collected using keywords derived from PICO. Only highly evidence based studies (randomised and non-randomised clinical trials) with the least risk of bias scores were selected, and critically appraised using the Critical Appraisal Skill Programme (CASP). Results were used to draw the conclusion. Material and Method: The study title was broken down into its PICO (population, intervention, comparative, outcome) components and search keywords were derived. These were used to carry out a literature search through electronic search engines (Medline-PUBMED, Science Direct, ISI Web of Knowledge, Research gate, Google Scholar, Cochrane library and hand searching of references list. Collected articles were assessed for risk of bias using Downs and Black (D&amp;B) scale. Papers with score ‘good’ and above’ on the D&amp;B assessment were critically appraised. PRISMA statement reporting format and Harvard referencing system were adopted in the study. Result: Following the Downs and Black assessment only 4 studies were found at a level worthy to be critically appraised. Results of all the four articles revealed that chin cup therapy produced significant growth modification in the mandible, when applied at an early age. Moreover, chin cup was also found to increase the lower anterior facial height significantly. All the papers considered only the short-term effect of chin cup, but not the long-term effect. Treatment results stability was also not reported. Conclusion: The significant improvement in CLIII manifestation in the selected articles, make it possible to conclude that chin cup is viable for the treatment of CLIII malocclusion with mandibular prognatism. However, treatment results stability needs to be researched.

Automated Orientation and Registration of Cone-Beam Computed Tomography Scans.

Automated clinical decision support systems rely on accurate analysis of three-dimensional (3D) medical and dental images to assist clinicians in diagnosis, treatment planning, intervention, and assessment of growth and treatment effects. However, analyzing longitudinal 3D images requires standardized orientation and registration, which can be laborious and error-prone tasks dependent on structures of reference for registration. This paper proposes two novel tools to automatically perform the orientation and registration of 3D Cone-Beam Computed Tomography (CBCT) scans with high accuracy (<3° and <2mm of angular and linear errors when compared to expert clinicians). These tools have undergone rigorous testing, and are currently being evaluated by clinicians who utilize the 3D Slicer open-source platform. Our work aims to reduce the sources of error in the 3D medical image analysis workflow by automating these operations. These methods combine conventional image processing approaches and Artificial Intelligence (AI) based models trained and tested on de-identified CBCT volumetric images. Our results showed robust performance for standardized and reproducible image orientation and registration that provide a more complete understanding of individual patient facial growth and response to orthopedic treatment in less than 5 min.

Incidence of a relationship between mandibular third molar impaction and different skeletal facial types

Introduction: It is seen that the failure of mandibular third molars to erupt is most affected by lack of space in the alveolar arch between the distal of the second molar and the ascending ramus. Variation in growth pattern in different facial forms affects the space available for tooth eruption; therefore, the mandibular third molar impaction has correlation with different skeletal facial types. Aim: The study aimed to investigate the relationship between mandibular third molar impaction and different skeletal facial types. Materials and Methods: The study sample consisted of lateral cephalometric and orthopantomogram of 350 individuals, aged 17–35 years who had visited the Department of Oral and Maxillofacial Facial Surgery, Daswani Dental College, Kota. The angulation of impaction was determined by the winter's classification and the facial type categorized by the facial axis angle. Results and Discussion: The overall rate of mandibular third molar impaction was 66.85%. Our study showed that mandibular third molar impaction is 3.3 times more common with the dolichofacial (38.7%) whereas brachyfacial (12.7%). Conclusion: After comparing the data with multiple studies, we found that the greater horizontal facial growth pattern of brachyfacial subjects over dolichofacial subjects provides increased space for full eruption of the mandibular third molar. Furthermore, bilateral mesioangular third molar impaction was more common with female predilection.

Digital evaluation and correlation of facial growth patterns assessed on lateral CEPH and orthopantomogram through ONECEPH mobile application

This study aimed to investigate the correlation of gonial angle and three linear measurements on OPG and lateral cephalograms and their effects on the different facial patterns using the OneCeph android app.About 90 pre-treatment digital lateral cephalograms and OPGs of 90 patients were selected and divided into 3 categories, based on their growth patterns. The OPGs and lateral cephalograms were uploaded on the OneCeph android app. After calibrating using One linear measurement i.e. length of extracted premolar for OPG and ruler in radiograph for lateral cephalogram, Gonial angle (Ar- Go-Me), ANS-Me (LAFH), U1-NF, L1-MP were measured. The data were collected, tabulated, and subjected to statistical analysis using the SPSS software (version 20.0). The level of significance was kept at 5%.Values for parameters were highest in the vertical growth pattern followed by average and horizontal in both cephalogram and OPG. Upon comparison of lateral cephalogram and OPG, no significant difference was observed in gonial angle and a significant difference in LAFH and L1-MP in all three growth patterns with OPG scores greater than cephalometric tracing. The interclass coefficient test indicated almost perfect agreement for the gonial angle between the two methods. A substantial agreement was seen for U1-NF on lateral cephalogram and OPG in the vertical group. Also, a fair agreement in the vertical and horizontal group was observed in Lower anterior mandibular height.Vertical parameters such as gonial angle and maxillary anterior dental height can be accurately determined on an OPG by the OneCeph application.

Septoplasty in peadiatric population

Septoplasty in children is controversials due to concerns over an adverse effect on nasal and facial growth. Recent evidence has confirmed that septoplasty can be safely performed without affecting nasofacial development in properly selected pediatric patient. The purpose of this article is to establish the impact of pediatric septoplasty on nasal and facial growth and review the clinical indications and evidence for timing of surgery according to the most recent literature. A structured review of the PubMed, Ovid Medline and Cochrane Collaboration databases (Cochrane Central Register of Controlled Trials, Cochrane Database of Systemic Reviews) was undertaken, using the terms: pediatric, childhood, septoplasty, nasal septum, indications, nasal growth and facial growth. A further similar study concluded that external septoplasty does not affect most aspects of nasal and facial growth, but may negatively influence growth of the nasal dorsum. Furthermore, one study demonstrated that a group of children with symptomatic uncorrected deviated nasal septum had a statistically significant increased occurrence of facial and dental anomalies compared with age and sex matched controls, therefore supporting a role for septoplasty. Conclusions: Evidence exists to support that pediatric septoplasty can be performed without affecting most aspects of nasal and facial growth.