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Tinano MM, Becker HMG, Franco LP, dos Anjos CPG, Ramos VM, Nader CMFF, Godinho J, de Párcia Gontijo H, Souki BQ. Morphofunctional changes following adenotonsillectomy of obstructive sleep apnea children: a case series analysis. Prog Orthod 2022; 23:29. [PMID: 35934732 PMCID: PMC9357578 DOI: 10.1186/s40510-022-00422-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 06/14/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Objective
To perform a case series analysis of the changes in the pulmonary artery systolic pressure (PASP), nasal inspiratory flow (NIF), upper airway volume, obstructive apnea/hypopnea index (OAHI), and the maxillomandibular three-dimensional (3D) morphology after adenotonsillectomy (T&A) of obstructive sleep apnea children (OSA).
Materials and methods
Retrospective assessment of files from 1002 children screened between 2012 and 2020 in a hospital-based mouth-breather referral center. From this universe, 15 obstructive sleep apnea children (7 females; 8 males), ages 4.1 to 8.9 years old (mean age of 5.4 years ± 1.3), who presented indications of tonsillectomy and/or adenoidectomy were selected. The complete baseline examination (T0) was carried out before T&A and a second complete examination (T1) was made 18.7-month follow-up after T&A (ranging from 12 to 30 months). Eleven patients were submitted to T&A, and four patients had indications but did not receive authorization for surgery from the public health system. According to the protocol of the outpatient clinic for OSA patients, Doppler echocardiography, polysomnography, rhinomanometry, and computed tomography imaging was performed at (T0) and (T1).
Results
PASP decreased 16.6% after T&A. NIF increased more in T&A children (40.3%) than in non-T&A children (16.8%). The upper airway volume increased in T&A and non-T&A children, but greater volumetric gain (45.6%) was found in the nasopharynx of T&A patients. OAHI did not change in six T&A children (55%) and three non-T&A children (75%). The maxilla displaced downward and backward relative to the cranial base in six T&A children (55%) and two untreated children (50%). Nine of the T&A children (85%) and three untreated children (75%) presented extensive condylar growth and increased mandibular length. The qualitative 3D assessment showed similar morphological 3D changes in T&A and non-T&A patients.
Conclusion
Pulmonary artery systolic pressure decreased, nasal inspiratory flow increased, and nasopharynx volume increased following adenotonsillectomy, but obstructive apnea/hypopnea index and maxillomandibular morphology were similar in surgical and non-surgical patients.
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Tong X, Li Y, Yang G, Zhang H, Jiang Y, Yu J, Da D, Zeng X, Liu Y. The Association of Tonsil Hypertrophy with Pediatric Dentofacial Development: Evidence from a Cross-Sectional Study of Young Children in Shanghai, China. Nat Sci Sleep 2022; 14:1867-1875. [PMID: 36284857 PMCID: PMC9588286 DOI: 10.2147/nss.s381020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 09/12/2022] [Indexed: 11/07/2022] Open
Abstract
PURPOSE The prevalence of dentofacial deformity was reportedly higher than decades ago, to which upper airway (UA) obstruction-induced sleep-disordered breathing (SDB) might contribute a lot. Tonsil hypertrophy appears relatively common in the population of young children. Given that the association between tonsil hypertrophy and pediatric dentofacial deformity remained controversial, this cross-sectional research was designed to explore the internal relationship of those among young children in Shanghai, China. PATIENTS AND METHODS A stratified cluster sampling procedure was adopted, and a representative sample of 715 young children (8-10 years old) was recruited. The OSA-18 quality-of-life questionnaires (OSA-18) were finished by their guardians, and well-trained orthodontists performed the oral examinations. After collecting the valuable information, the descriptions and analyses were run by statistical software (SPSS, version 26.0). RESULTS 715 participants (334 boys and 381 girls) were involved in the analyses. As calculated, the current prevalence of malocclusion identified by Angle's classification was 45.6% in this sample. No evident relation between OSA-18 scores and dentofacial abnormalities (P > 0.05) was found. With the enlargement of tonsil size, the proportion of children with triangular dental arch form (P < 0.05) and high vault palate (P < 0.001) was increasingly higher. More children with protruding profiles and fewer upright profiles were observed as the tonsil size increased, although it did not show a statistical difference (P = 0.103). CONCLUSION Dental and craniofacial growth deficiency has become more prevalent among children, demanding more concerns from health authorities. Tonsil hypertrophy plays an essential role in the direction of dentofacial development. More efforts from local health authorities should be made to enhance public propaganda and education on the prevention and interruption of tonsil hypertrophy and related dentofacial abnormalities.
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Affiliation(s)
- Xianqin Tong
- Department of Orthodontics, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, People's Republic of China
| | - Yuanyuan Li
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, People's Republic of China.,Department of Preventive Dentistry, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, People's Republic of China
| | - Gang Yang
- Department of Orthodontics, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, People's Republic of China
| | - Hao Zhang
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, People's Republic of China.,Department of Pediatric Dentistry, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, People's Republic of China
| | - Yiwei Jiang
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, People's Republic of China.,Department of Pediatric Dentistry, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, People's Republic of China
| | - Jin Yu
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, People's Republic of China.,Department of Pediatric Dentistry, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, People's Republic of China
| | - Dongxin Da
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, People's Republic of China.,Department of Pediatric Dentistry, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, People's Republic of China
| | - Xiaoli Zeng
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, People's Republic of China.,Department of Pediatric Dentistry, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, People's Republic of China
| | - Yuehua Liu
- Department of Orthodontics, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, People's Republic of China
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Ozawa E, Honda EI, Tomizato H, Kurabayashi T, Nunthayanon K, Ohmori H, Shimazaki K, Ono T. Preliminary study of articulatory characteristics in open bite subjects revealed by 3T magnetic resonance imaging movies. APOS TRENDS IN ORTHODONTICS 2021. [DOI: 10.25259/apos_174_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives:
Previous studies have reported that articulatory dysfunction accompanied by a certain type of malocclusion can be improved by orthodontic treatment. We developed a 3-T magnetic resonance imaging (MRI) movie method with tooth visualization that can display the dynamic movement of articulation without radiation exposure. To the best of our knowledge, there is currently no report on the possible differences in articulatory movement between subjects with a normal occlusion and those with malocclusion using the 3T MRI movie method. Thus, the objective of this study was to examine the articulatory difference between subjects with a normal occlusion and those with an open bite using an MRI movie.
Materials and Methods:
Twenty healthy adult females, ten with a normal occlusion and ten with an anterior open bite were recruited. The overbite of the open bite subjects was zero or smaller, and all of them exhibited a tongue-thrusting habit during swallowing. A turbo spin echo image with a contrast medium was used to visualize the anterior teeth, and articulatory movement during articulation of the vowel-consonant-vowel syllable (/asa/) was scanned. The difference in tongue movement between subjects with a normal occlusion and those with an open bite was compared by measuring seven variables. Moreover, the distance between the incisal edge and the tongue apex during articulation of /s/ and the speech duration were compared. Furthermore, frequency analysis on /s/ by fast Fourier transform power spectrum was performed.
Results:
The tongue apex of the open bite subjects moved more anteriorly than that of the normal subjects. However, there was no significant difference in the phonetic analysis between subjects with a normal occlusion and those with an open bite.
Conclusion:
The 3-T MRI movie was an efficient method to quantify articulatory tongue movements. Although there was a difference in tongue movement during swallowing between subjects with a normal occlusion and those with an open bite, the difference in the articulatory tongue movements was minimal, suggesting it could be a functional compensation.
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Affiliation(s)
- Erika Ozawa
- Department of Orthodontic Science, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Tokyo, Japan
| | - Ei-ichi Honda
- Department of Oral and Maxillofacial Radiology, University of Tokushima, Tokushima-shi, Tokushima-kenn, Japan
| | - Hiroshi Tomizato
- Department of Oral and Maxillofacial Radiology, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Tokyo, Japan,
| | - Tohru Kurabayashi
- Department of Oral and Maxillofacial Radiology, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Tokyo, Japan,
| | - Kulthida Nunthayanon
- Department of Preventive Dentistry, Orthodontic Division, Naresuan University, Mueang Phitsanulok, Thailand,
| | - Hiroko Ohmori
- Department of Orthodontic Science, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Tokyo, Japan
| | - Kazuo Shimazaki
- Department of Orthodontic Science, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Tokyo, Japan
| | - Takashi Ono
- Department of Orthodontic Science, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Tokyo, Japan
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Li Y, Wu J, Guo J, Yu L, Wang J, Li X, Xu S, Zhu M, Feng J, Liu Y. The efficacy of different treatment approaches for pediatric OSAHS patients with mandibular retrognathia: study protocol for a multicenter randomized controlled trial. Trials 2020; 21:595. [PMID: 32605655 PMCID: PMC7329444 DOI: 10.1186/s13063-020-04398-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 05/08/2020] [Indexed: 02/07/2023] Open
Abstract
Background Pediatric obstructive sleep apnea/hypopnea syndrome (OSAHS) is a multifactorial syndrome caused by many risk factors, such as craniofacial anomalies, adenotonsillar hypertrophy, obesity, and airway inflammation. Although new treatment patterns have recently been proposed, treatment methods for children remain particularly challenging and controversial. This randomized controlled trial was designed to investigate the efficacy of adenotonsillectomy and/or orthodontic treatment for children who have mild OSAHS with mandibular retrognathia. Methods A sample of 352 children with mild OSAHS and mandibular retrognathia, who are aged between 7 and 10 years, will be enrolled in the study. They will be randomized into four groups: the drug treatment group, the surgical treatment group, the orthodontic treatment group, or the surgery and postoperative orthodontic group. After randomization the children will receive treatments within 4 weeks. Outcome assessment will take place at the following points: (1) baseline, (2) 7 months after the treatment starting point, (3) 12 months after the treatment starting point, and (4) 24 months after the treatment starting point. The primary endpoint of the trial is the mean change in obstructive apnea/hypopnea index. Other endpoints will consist of the lowest oxygen saturation, apnea index, and hypopnea index assessed by polysomnography, subjective symptoms (assessed by the OSA-20 questionnaire), cephalometric measurements, and morphologic analysis of the upper airway. Discussion The results of this study will provide valuable evidence for the merits and long-term efficacy of different treatment approaches and contribute to facilitating the multidisciplinary treatment of pediatric OSAHS. Trial registration ClinicalTrials.gov: NCT03451318. Registered on 2 March 2018 (last update posted 19 April 2018).
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Affiliation(s)
- Yuanyuan Li
- Department of Pediatric Dentistry, Shanghai Stomatological Hospital, Fudan University, Shanghai, China.,Oral Biomedical Engineering Laboratory, Shanghai Stomatological Hospital, Fudan University, Shanghai, China
| | - Jiali Wu
- Department of Otolaryngology and Head and Neck Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jinghan Guo
- Oral Biomedical Engineering Laboratory, Shanghai Stomatological Hospital, Fudan University, Shanghai, China.,Department of Orthodontics, Shanghai Stomatological Hospital, Fudan University, Shanghai, China
| | - Liming Yu
- Oral Biomedical Engineering Laboratory, Shanghai Stomatological Hospital, Fudan University, Shanghai, China.,Department of Orthodontics, Shanghai Stomatological Hospital, Fudan University, Shanghai, China
| | - Jing Wang
- Department of Otolaryngology and Head and Neck Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoyan Li
- Department of Otolaryngology and Head and Neck Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuhua Xu
- Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Min Zhu
- Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Jinqiu Feng
- Department of Pediatric Dentistry, Shanghai Stomatological Hospital, Fudan University, Shanghai, China.,Oral Biomedical Engineering Laboratory, Shanghai Stomatological Hospital, Fudan University, Shanghai, China
| | - Yuehua Liu
- Oral Biomedical Engineering Laboratory, Shanghai Stomatological Hospital, Fudan University, Shanghai, China. .,Department of Orthodontics, Shanghai Stomatological Hospital, Fudan University, Shanghai, China.
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Pawłowska-Seredyńska K, Umławska W, Resler K, Morawska-Kochman M, Pazdro-Zastawny K, Kręcicki T. Craniofacial proportions in children with adenoid or adenotonsillar hypertrophy are related to disease duration and nasopharyngeal obstruction. Int J Pediatr Otorhinolaryngol 2020; 132:109911. [PMID: 32032918 DOI: 10.1016/j.ijporl.2020.109911] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 01/25/2020] [Accepted: 01/27/2020] [Indexed: 01/17/2023]
Affiliation(s)
| | - Wioleta Umławska
- Department of Human Biology, University of Wroclaw, Ul. Kuźnicza 35, 50-138, Wroclaw, Poland
| | - Katarzyna Resler
- Clinic of Otolaryngology Head and Neck Surgery, Wroclaw Medical University, Ul. Borowska 213, 50-556, Wroclaw, Poland
| | - Monika Morawska-Kochman
- Clinic of Otolaryngology Head and Neck Surgery, Wroclaw Medical University, Ul. Borowska 213, 50-556, Wroclaw, Poland
| | - Katarzyna Pazdro-Zastawny
- Clinic of Otolaryngology Head and Neck Surgery, Wroclaw Medical University, Ul. Borowska 213, 50-556, Wroclaw, Poland
| | - Tomasz Kręcicki
- Clinic of Otolaryngology Head and Neck Surgery, Wroclaw Medical University, Ul. Borowska 213, 50-556, Wroclaw, Poland
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6
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Yap B, Kontos A, Pamula Y, Martin J, Kennedy D, Sampson W, Dreyer C. Differences in dentofacial morphology in children with sleep disordered breathing are detected with routine orthodontic records. Sleep Med 2019; 55:109-114. [DOI: 10.1016/j.sleep.2018.12.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 12/07/2018] [Accepted: 12/14/2018] [Indexed: 11/17/2022]
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7
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Anderson SM, Lim HJ, Kim KB, Kim SW, Kim SJ. Clustering of craniofacial patterns in Korean children with snoring. Korean J Orthod 2017; 47:248-255. [PMID: 28670566 PMCID: PMC5466907 DOI: 10.4041/kjod.2017.47.4.248] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 01/20/2017] [Accepted: 02/07/2017] [Indexed: 11/10/2022] Open
Abstract
Objective The purpose of this study was to investigate whether the craniofacial patterns of Korean children with snoring and adenotonsillar hypertrophy (ATH) could be categorized into characteristic clusters according to age. Methods We enrolled 236 children with snoring and ATH (age range, 5–12 years) in this study. They were subdivided into four age groups: 5–6, 7–8, 9–10, and 11–12 years. Based on cephalometric analysis, the sagittal and vertical skeletal patterns of each individual were divided into Class I, II, and III, as well as the normodivergent, hypodivergent, and hyperdivergent patterns, respectively. Cluster analysis was performed using cephalometric principal components in addition to the age factor. Results Three heterogeneous clusters of craniofacial patterns were obtained in relation to age: cluster 1 (41.9%) included patients aged 5–8 years with a skeletal Class I or mild Class II and hyperdivergent pattern; cluster 2 (45.3%) included patients aged 9–12 years with a Class II and hyperdivergent pattern; and cluster 3 (12.8%) included patients aged 7–8 years with a Class III and hyperdivergent pattern. Conclusions This study found that the craniofacial patterns of Korean children with snoring and ATH could be categorized into three characteristic clusters according to age groups. Although no significantly dominant sagittal skeletal discrepancy was observed, hyperdivergent vertical discrepancy was consistently evident in all clusters.
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Affiliation(s)
| | - Hoi-Jeong Lim
- Department of Orthodontics, Chonnam National University School of Dentistry, Gwangju, Korea
| | - Ki-Beom Kim
- Department of Orthodontics, Center for Advanced Dental Education, Saint Louis University, St. Louis, MO, USA
| | - Sung-Wan Kim
- Department of Otorhinolaryngology Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea
| | - Su-Jung Kim
- Department of Orthodontics, Kyung Hee University School of Dentistry, Seoul, Korea
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8
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Bozzini MFR, Di Francesco RC. Managing obstructive sleep apnoea in children: the role of craniofacial morphology. Clinics (Sao Paulo) 2016; 71:664-666. [PMID: 27982168 PMCID: PMC5108167 DOI: 10.6061/clinics/2016(11)08] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 08/17/2016] [Indexed: 11/18/2022] Open
Abstract
Obstructive sleep apnoea syndrome is a type of sleep-disordered breathing that affects 1 to 5% of all children. Pharyngeal and palatine tonsil hypertrophy is the main predisposing factor. Various abnormalities are predisposing factors for obstructive sleep apnoea, such as decreased mandibular and maxillary lengths, skeletal retrusion, increased lower facial height and, consequently, increased total anterior facial height, a larger cranio-cervical angle, small posterior airway space and an inferiorly positioned hyoid bone. The diagnosis is based on the clinical history, a physical examination and tests confirming the presence and severity of upper airway obstruction. The gold standard test for diagnosis is overnight polysomnography. Attention must be paid to identify the craniofacial characteristics. When necessary, children should be referred to orthodontists and/or sleep medicine specialists for adequate treatment in addition to undergoing an adenotonsillectomy.
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9
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Zhu Y, Li J, Tang Y, Wang X, Xue X, Sun H, Nie P, Qu X, Zhu M. Dental arch dimensional changes after adenoidectomy or tonsillectomy in children with airway obstruction: A meta-analysis and systematic review under PRISMA guidelines. Medicine (Baltimore) 2016; 95:e4976. [PMID: 27684847 PMCID: PMC5265940 DOI: 10.1097/md.0000000000004976] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Revised: 06/01/2016] [Accepted: 09/05/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Children with severe airway obstruction tend to have a vertical direction of growth, class II malocclusion, and narrow arches. Adenoidectomy and tonsillectomy were recommended for the promotion of balanced dentition growth in these children.The aim of this study was to determine the effect of adenoidectomy and tonsillectomy on the growth of dental morphology in children with airway obstruction. METHODS A comprehensive search of the Medline, Embase, Web of science, and OVID databases for studies published through to January 17, 2016 was conducted. Prospective, comparative, clinical studies assessing the efficacy of adenoidectomy, or tonsillectomy in children with airway obstruction were included. The weighted mean difference (WMD) and 95% confidence interval (CI) were used for continuous variables. Forest plots were drawn to demonstrate effects in the meta-analyses. RESULTS Eight papers were included in our study. We found that adenoidectomy and tonsillectomy led to a significant change in nasal-breathing in children with airway obstruction. Children with airway obstruction had a significantly narrower posterior maxillary dental arch than children without airway obstruction (WMD = -0.94, 95% CI [-1.13, -0.76]; P < 0.001). After surgery, these children still had a significantly narrower dental arch than the nasal-breathing children (WMD = -0.60, 95% CI [-0.79, -0.42]; P < 0.001). In terms of dental arch width, malocclusion, palatal height, overjet, overbite, dental arch perimeter, and arch length, a tendency toward normalization was evident following adenoidectomy or tonsillectomy, with no significant differences evident between the surgical group and the normal group. The small number of studies and lack of randomized controlled trials were the main limitations of this meta-analysis. CONCLUSIONS Following adenoidectomy and tonsillectomy, the malocclusion and narrow arch width of children with airway obstruction could not be completely reversed. Therefore, other treatments such as functional training or orthodontic maxillary widening should be considered after removing the obstruction in the airway.
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Affiliation(s)
- Yanfei Zhu
- College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai
| | - Jiaying Li
- Jining Medical University, Jining, Shandong
| | - Yanmei Tang
- College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai
| | - Xiaoling Wang
- College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai
| | - Xiaochen Xue
- College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai
| | - Huijun Sun
- College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai
| | - Ping Nie
- College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai
- Department of Oral and Cranio-Maxillofacial Science
| | - Xinhua Qu
- Department of Orthopaedics, Shanghai Ninth People's Hospital
- Shanghai Key Laboratory of Orthopaedic Implant
| | - Min Zhu
- College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai
- Department of Oral and Cranio-Maxillofacial Science
- Shanghai Key Laboratory of Stomatology, Shanghai, China
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10
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Niemi P, Numminen J, Rautiainen M, Helminen M, Vinkka-Puhakka H, Peltomäki T. The effect of adenoidectomy on occlusal development and nasal cavity volume in children with recurrent middle ear infection. Int J Pediatr Otorhinolaryngol 2015; 79:2115-9. [PMID: 26454528 DOI: 10.1016/j.ijporl.2015.09.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 09/17/2015] [Accepted: 09/21/2015] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The aim of the study was to examine the effect of adenoidectomy on occlusal/dentoalveolar development and nasal cavity volume in children who underwent tympanostomy tube insertion with or without adenoidectomy due to recurrent episodes of middle ear infection. METHODS This prospective controlled study consisted of two randomly allocated treatment groups of children, younger than 2 years, who had underwent more than 3-5 events of middle ear infection during the last 6 months or 4-6 events during the last year. At the mean age of 17 months tympanostomy tube placement without adenoidectomy (Group I, n=63) tympanostomy tube placement with adenoidectomy (Group II, n=74) was performed. At the age of 5 years 41 children of the original Group I (14 females, 27 males, mean age 5.2 yrs, SD 0.17) and 59 children of the original Group II (17 females, 42 males, mean age 5.2 yrs, SD 0.18) participated in the re-examination, which included clinical orthodontic examination defining morphological and functional craniofacial status and occlusal bite index to measure upper dental arch dimensions. Acoustic rhinometry and anterior rhinomanometry was made by otorhinolaryngologist at the same day. RESULTS No statistically significant differences were found between the groups in the frequencies of morphological or functional characteristics or upper dental arch measurements or in the minimal cross-sectional areas or inspiratory nasal airway resistance measurements. CONCLUSION Combining adenoidectomy with tympanostomy tube insertion in the treatment of recurrent middle ear infection at an early age (under the age of 2 years) does not seem to make any difference in occlusal development in primary dentition at the age of 5 years as compared to tympanostomy tube insertion only. Since adenoid size was not evaluated, the findings do not allow interpretation that hypertrophic adenoids should not be removed in children with continuous mouth breathing or sleep disordered breathing.
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Affiliation(s)
- P Niemi
- Department of Maxillofacial Surgery and Oral Diseases, Satakunta Central Hospital, Pori, Finland
| | - J Numminen
- Department of Otorhinolaryngology, Tampere University Hospital, and University of Tampere, Finland
| | - M Rautiainen
- Department of Otorhinolaryngology, Tampere University Hospital, and University of Tampere, Finland
| | - M Helminen
- Science Centre, Pirkanmaa Hospital District and School of Health Sciences, University of Tampere, Finland
| | | | - T Peltomäki
- Field of Dentistry, University of Tampere, and Oral and Maxillofacial Unit, Tampere University Hospital, Finland.
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11
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Kim DK, Rhee CS, Yun PY, Kim JW. Adenotonsillar hypertrophy as a risk factor of dentofacial abnormality in Korean children. Eur Arch Otorhinolaryngol 2014; 272:3311-6. [PMID: 25490975 DOI: 10.1007/s00405-014-3407-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 11/21/2014] [Indexed: 11/29/2022]
Abstract
No studies for the role of adenotonsillar hypertrophy in development of dentofacial abnormalities have been performed in Asian pediatric population. Thus, we aimed to investigate the relationship between adenotonsillar hypertrophy and dentofacial abnormalities in Korean children. The present study included consecutive children who visited a pediatric clinic for sleep-disordered breathing due to habitual mouth breathing, snoring or sleep apnea. Their palatine tonsils and adenoids were graded by oropharyngeal endoscopy and lateral cephalometry. Anterior open bite, posterior crossbite, and Angle's class malocclusions were evaluated for dentofacial abnormality. The receiver-operating characteristic curve analysis was used to identify age cutoffs to predict dentofacial abnormality. A total of 1,083 children were included. The presence of adenotonsillar hypertrophy was significantly correlated with the prevalence of dentofacial abnormality [adjusted odds ratio = 4.587, 95% CI (2.747-7.658)] after adjusting age, sex, body mass index, allergy, and Korean version of obstructive sleep apnea-18 score. The cutoff age associated with dentofacial abnormality was 5.5 years (sensitivity = 75.5%, specificity = 67%) in the children with adenotonsillar hypertrophy and 6.5 years (sensitivity = 70.6%, specificity = 57%) in those without adenotonsillar hypertrophy. In conclusion, adenotonsillar hypertrophy may be a risk factor for dentofacial abnormalities in Korean children and early surgical intervention could be considered with regards to dentofacial abnormality.
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Affiliation(s)
- Dong-Kyu Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, South Korea
| | - Chae Seo Rhee
- Departments of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 173 Goomi-ro, Bundang-gu, 463-707, Seongnam, South Korea
| | - Pil-Young Yun
- Oral and Maxillofacial Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jeong-Whun Kim
- Departments of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 173 Goomi-ro, Bundang-gu, 463-707, Seongnam, South Korea.
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Carvalho FR, Lentini-Oliveira DA, Carvalho GMM, Prado LBF, Prado GF, Carvalho LBC. Sleep-disordered breathing and orthodontic variables in children--pilot study. Int J Pediatr Otorhinolaryngol 2014; 78:1965-9. [PMID: 25242700 DOI: 10.1016/j.ijporl.2014.08.040] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 08/20/2014] [Accepted: 08/21/2014] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Sleep Disordered Breathing (SDB) is a highly prevalent condition associated with orofacial and dentofacial characteristics. OBJECTIVE The aim of this study was to verify the association of dental malocclusion, molar relationship, crossbite, open bite, overjet, overbite, and crowding with SDB in children aged 7-9 years. MATERIALS AND METHODS Participating schools were selected randomly from within the public elementary school system. In the first phase of the study, the parents of 1216 children aged between 7 and 9 years old completed the Sleep Disturbance Scale for Children (SDSC) questionnaire and the children had to participate in a dental examination. The evaluation of occlusion was divided into sagittal analysis, vertical analysis, and transverse analysis. In the second phase, 60 children were selected randomly to be undergone polysomnography (PSG) at a sleep clinic. RESULTS Among the children included, 242 (19.9%) children had normal occlusion. Of the 60 children, 50 underwent PSG and 40 (80%) had SDB. The crossbite and open bite showed association with SDB, p=0.04 in both. CONCLUSION Crossbite and open bite malocclusions were associated with SDB, and may be predictive of SDB in children. Studies with larger numbers of participants are needed to investigate the association of other malocclusions with SDB, and randomized clinical trials are also needed to see whether orthodontic and/or functional jaw orthopedic treatment is an option for treating children with malocclusion and SDB.
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Ericsson E, Graf J, Lundeborg-Hammarstrom I, Hultcrantz E. Tonsillotomy versus tonsillectomy on young children: 2 year post surgery follow-up. J Otolaryngol Head Neck Surg 2014; 43:26. [PMID: 25064139 PMCID: PMC6389138 DOI: 10.1186/s40463-014-0026-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Indexed: 11/24/2022] Open
Abstract
Objectives To study the long-term effect of tonsillotomy and tonsillectomy in young children after two years in comparison to the results after six months. Method Children, age 4-5 with Sleep Disordered Breathing (SDB) and tonsil hyperplasia, were randomized to TE (32) or TT (35). TT was performed ad modum Hultcrantz with radiofrequency technique (Ellman). An adenoidectomy with cold steel was performed in the same session for 80% of cases. The patients were assessed prior to surgery, at six and 24 months postoperatively. Effects of surgery were evaluated clinically, through questionnaire (general health/snoring/ENT-infections), Quality of Life (QoL), survey of pediatric obstructive sleep apnea with OSA-18, and children’s behavior with the Child Behavior Checklist. Results After two years there was still no difference between the groups with respect to snoring and frequency or severity of upper airway infections. Both TT and TE had resulted in large improvement in short and long term QoL and behavior. Three TT-children and one TE child had been re-operated due to recurrence of obstructive problems, the TE-child and one of the TT-children with adenoidectomy and two of the TT-children with tonsillectomy. Three of the TT-children had tonsil tissue protruding slightly out of the tonsil pouch and twelve TE-children had small tonsil remnants within the tonsil pouches, but with no need for surgery. Conclusion Younger children have a small risk of symptom-recurrence requiring re-surgery within two years after TT. For the majority, the positive effect on snoring, infections, behavior and quality of life remain and is similar to TE. Electronic supplementary material The online version of this article (doi:10.1186/s40463-014-0026-6) contains supplementary material, which is available to authorized users.
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Craniofacial morphological characteristics in children with obstructive sleep apnea syndrome: a systematic review and meta-analysis. J Am Dent Assoc 2014; 144:269-77. [PMID: 23449902 DOI: 10.14219/jada.archive.2013.0113] [Citation(s) in RCA: 103] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The authors conducted a systematic review to consolidate the current knowledge regarding craniofacial morphological characteristics associated with obstructive sleep apnea syndrome (OSAS) in nonsyndromic pediatric patients. TYPES OF STUDIES REVIEWED The authors included clinical studies in which participants were younger than 18 years, polysomnography was performed to determine the presence and severity of OSAS and the study group was compared with a control group or normative growth center data. The authors excluded studies with syndromic participants or participants who had received orthodontic treatment, orthognathic treatment or both previously. RESULTS The authors identified nine articles. They conducted a meta-analyses of the data from all but one of the studies to evaluate the eight most common cephalometric variables in children with OSAS. The I(2) values were 79.53 percent for the angle from the basion point to the sella nasion (SN) line, 89.54 percent for the angle between the SN and palatal plane lines and 96.82 percent for the angle between the mandibular plane and SN lines (MP-SN). Therefore, for these three variables, the authors conducted a random-effect model meta-analysis. For the remaining five variables (MP-SN, the angle from SN to Apoint, the angle from SN to B point [SNB], the angle from A point to nasion point to B point [ANB] and the angle from articulare point to gonion point to gnathion point), I(2) values were all less than 40 percent, and therefore the authors conducted a fixed-effects model meta-analysis. Three of the evaluated cephalometric variables (MP-SN, SNB and ANB) had statistically significant differences in comparison with those in a control group. Although the values of these variables were increased in children with OSAS, results of the meta-analysis should be considered cautiously owing to the limited number of cephalometric variables included. PRACTICAL IMPLICATIONS Dentists who identify patients with a craniofacial morphology consistent with pediatric OSAS (retrusive chin, steep mandibular plane, vertical direction of growth and a tendency toward Class II malocclusion) should inquire further into their patients' medical histories. When the craniofacial morphology is accompanied by a history of snoring, inability to breathe through the nose, significant allergies, asthma or obesity, the dentist should refer the patient to an otolaryngologist for assessment.
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Craniofacial and upper airway morphology in pediatric sleep-disordered breathing and changes in quality of life with rapid maxillary expansion. Am J Orthod Dentofacial Orthop 2013; 144:860-71. [DOI: 10.1016/j.ajodo.2013.08.015] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Revised: 08/01/2013] [Accepted: 08/01/2013] [Indexed: 12/21/2022]
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Kallunki J, Marcusson A, Ericsson E. Tonsillotomy versus tonsillectomy--a randomized trial regarding dentofacial morphology and post-operative growth in children with tonsillar hypertrophy. Eur J Orthod 2013; 36:471-8. [PMID: 24253034 DOI: 10.1093/ejo/cjt082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES The primary aim of this study was to analyse two different methods of tonsil surgery, tonsillectomy (TE) and tonsillotomy (TT), regarding post-operative dentofacial growth in children with tonsillar hypertrophy. A secondary aim was to analyse these results in relation to cephalometric standards. MATERIAL AND METHODS The study group consisted of 64 subjects (39 boys and 25 girls), mean age 4.8 years ± 4 months. They were randomized to a complete removal of the pharyngeal tonsil, TE, (n = 31) or a partial removal, TT, (n = 33). Pre-operative and 2 years post-operative study material were obtained and analysed. The results were compared with cephalometric standards. RESULTS Pre-operative, children with hypertrophic tonsils displayed an increased vertical relation (P < 0.05) compared with cephalometric standards. Post-operative, no significant difference could be detected between the two surgical procedures regarding dentofacial growth. Mandibular growth with an anterior inclination was significant (P < 0.001/TE, P < 0.01/TT) for both groups. An increased upper and lower incisor inclination was noted (P < 0.01/TE,TT). The vertical relation decreased (P < 0.001/TE, P < 0.05/TT) as well as the mandibular angle (P < 0.01/TE, P < 0.001/TT). Reduction was also significant for the sagittal intermaxillar (P < 0.001/TE,TT) relation. These post-operative results, together with a more prognatic mandible (P < 0.05/TE,TT) and chin (P < 0.001/TE, P < 0.01/TT), might indicate a more horizontal direction of mandibular growth. CONCLUSION TE and TT yielded equal post-operative dentofacial growth in children treated for hypertrophic tonsils. This result should be considered when deciding upon surgical technique.
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Affiliation(s)
| | - Agneta Marcusson
- **Departments of Dentofacial Orthopaedics, University Hospital and
| | - Elisabeth Ericsson
- ***Medical and Health Sciences, Linköping University and Anesthesia and Intensive Care , County Council of Östergötland, Linköping, Sweden
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Brigger MT, Hultcrantz E, Ericsson E, Lowe D. Comments to ORL 2013;75:193-202 (DOI: 10.1159/000342329). ORL J Otorhinolaryngol Relat Spec 2013; 75:203-4. [PMID: 23978810 DOI: 10.1159/000353491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Hultcrantz E, Ericsson E. Factors Influencing the Indication for Tonsillectomy: A Historical Overview and Current Concepts. ACTA ACUST UNITED AC 2013; 75:184-91. [DOI: 10.1159/000342322] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Childhood obstructive sleep apnea syndrome: an interdisciplinary approach: a prospective epidemiological study of 4,318 five-and-a-half-year-old children. J Orofac Orthop 2012; 73:342-58. [PMID: 22874975 DOI: 10.1007/s00056-012-0096-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Accepted: 03/26/2012] [Indexed: 01/09/2023]
Abstract
UNLABELLED Population-representative data on sleep disorders in children is scarce. BACKGROUND AND OBJECTIVE The aim of this epidemiological study was to determine the prevalence of various sleep-related breathing disorders (SRBD) and any correlations with occlusion and jaw abnormalities in preschool children. MATERIALS AND METHODS The study material consisted of 4,318 children (5.5 years old) whose parents completed the Pediatric Sleep Questionnaire (PSQ); 60 out of 140 children (6.3 ± 0.78 years old) with a positive questionnaire score (> 0.33) were examined by an orthodontist and ENT specialist. From this cohort, 15 children who presented a dental occlusion and jaw abnormality but no indication for surgical reduction of adenotonsillar tissue underwent polysomnography in a sleep laboratory. RESULTS According to the PSQ, 3.3% of the 5.5-year-olds showed evidence of a SRBD. Boys were affected significantly more frequently. Lack of concentration, hyperactivity, morning fatigue, mouth breathing, loud snoring, and breathing interruptions were indicators of SRBD. The SRBD children more frequently presented with jaw abnormalities such as mandibular retrognathia, lateral cross-bite, and increased overjet. The SRBD cohort showed a higher rate of orofacial dysfunctions. Adenotonsillar hyperplasia still played a significant role in the development of SRBD. CONCLUSION In contrast to previous reports in the literature, the frequency of SRBD in our group of 5- to 6-year-olds was lower (3%). Boys with adenotonsillar hyperplasia and/or mandibular retrognathia, lateral cross bite, and an enlarged overjet require special attention.
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Vieira BB, Sanguino ACM, Mattar SE, Itikawa CE, Anselmo-Lima WT, Valera FCP, Matsumoto MAN. Influence of adenotonsillectomy on hard palate dimensions. Int J Pediatr Otorhinolaryngol 2012; 76:1140-4. [PMID: 22621956 DOI: 10.1016/j.ijporl.2012.04.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Revised: 04/17/2012] [Accepted: 04/18/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate hard palate width and height in mouth-breathing children pre- and post-adenotonsillectomy. METHODS We evaluated 44 children in the 3-6 year age bracket, using dental study casts in order to determine palatal height, intercanine width, and intermolar width. The children were divided into two groups: nasal breathing (n=15) and mouth breathing (n=29). The children in the latter group underwent adenotonsillectomy. The study casts were obtained prior to adenotonsillectomy, designated time point 1 (T1), at 13 months after adenotonsillectomy (T2), and at 28 months after adenotonsillectomy (T3). Similar periods of observation were obtained for nasal breathing children. RESULTS At T1, there was a significantly lower intercanine width in mouth breathing children; intermolar width and palate height were similar between groups. After surgery, there was a significant increase in all the analyzed parameters in both groups, probably due to facial growth. Instead, the increase in intercanine width was substantially more prominent in mouth breathing children than in nasal breathing children, and the former difference failed in significance after the procedure. CONCLUSIONS There were no significant differences between the nasal-breathing and mouth-breathing children in terms of intermolar width and palatal height prior to or after tonsillectomy. Although intercanine width was initially narrower in the mouth-breathing children, it showed normalization after the surgical procedure. These results confirm that the restoration of nasal breathing is central to proper occlusal development.
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Affiliation(s)
- Bruno Boaventura Vieira
- Department of Orthodontics, University of São Paulo at Ribeirão Preto School of Dentistry, Ribeirão Preto, SP, Brazil.
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Parental-reported snoring from the first month of life and cognitive development at 12months of age. Sleep Med 2011; 12:975-80. [DOI: 10.1016/j.sleep.2011.07.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Revised: 07/04/2011] [Accepted: 07/14/2011] [Indexed: 11/20/2022]
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Esteller Moré E, Pons Calabuig N, Romero Vilariño E, Puigdollers Pérez A, Segarra Isern F, Matiñó Soler E, Ademà Alcover JM. [Dentofacial development abnormalities in paediatric sleep-related breathing disorders]. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2011; 62:132-9. [PMID: 21215380 DOI: 10.1016/j.otorri.2010.10.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2010] [Revised: 10/18/2010] [Accepted: 10/20/2010] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The recent interest in sleep-related breathing disorders has re-opened the old debate as to whether there is a causal relationship between upper respiratory obstruction and abnormalities in dentofacial development. OBJECTIVE To establish the impact of dentofacial development on sleep-related breathing disorders in children. METHOD This is a prospective study in which the dentofacial studies of 30 children, diagnosed with a sleep-related breathing disorder using polysomnography, were compared with a control group of 30 healthy children. The ages of both groups were between 3 and 13 years. RESULTS The statistical analysis showed significant differences between the groups in the proportion of children with a narrow palate (83% of the problem group and 57% in the control; P=0.024) and cross bite (40% and 13%; P=0.020). On comparing the angles measured, the only statistically-significant difference was the skull base-mandibular plane angle: The problem children group had a mean of 37.59±5.56 and the control group, a mean of 34.41±4.62 (P=0.023). CONCLUSION Children with sleep-related breathing disorders have abnormalities in facial and dental development caused by upper respiratory obstruction. These anomalies, vertical growth of the face, narrow palate and dental occlusion changes should be taken into account when assessing the indication for a adenotonsillectomy.
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Affiliation(s)
- Eduard Esteller Moré
- Servicio de Otorrinolaringología, Hospital General de Catalunya, Sant Cugat del Vallès, Barcelona, Spain.
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Lundeborg I, Ericsson E, Hultcrantz E, McAllister AM. Influence of adenotonsillar hypertrophy on /s/-articulation in children--effects of surgery. LOGOP PHONIATR VOCO 2010; 36:100-8. [PMID: 21133642 DOI: 10.3109/14015439.2010.531047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Tonsillar hypertrophy is common in young children and affects several aspects of the speech such as distortions of the dento-alveolar consonants. The study objective was to assess /s/-articulation, perceptually and acoustically, in children with tonsillar hypertrophy and compare effects of two types of surgery, total tonsillectomy and tonsillotomy. Sixty-seven children, aged 50-65 months, on the waiting list for surgery, were randomized to tonsillectomy or tonsillotomy. The speech material was collected preoperatively and 6 months postoperatively. Two groups of age-matched children were controls. /S/-articulation was affected acoustically with lower spectral peak locations and perceptually with less distinct /s/-production before surgery, in comparison to controls. After surgery /s/-articulation was normalized perceptually, but acoustic differences remained. No significant differences between surgical methods were found.
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Affiliation(s)
- Inger Lundeborg
- Linköping University, Department of Clinical and Experimental Medicine, IKE/Speech Language Pathology, Faculty of Health Sciences, Linköping, Sweden.
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Cobo Plana J, de Carlos Villafranca F. Trastornos respiratorios del sueño y desarrollo dentofacial en los niños. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2010; 61 Suppl 1:33-9. [DOI: 10.1016/s0001-6519(10)71243-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Gunhan K, Can F, Uz U, Serter S, Unlu H. Does maxillary arch remodeling exist in nasal polyposis? Am J Rhinol Allergy 2010; 24:428-32. [PMID: 20943014 DOI: 10.2500/ajra.2010.24.3546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The potential transformation in the maxillary complex morphology is mostly complete during childhood. Recent studies suggest a nasal tissue remodeling both in the overlying mucosa and in the underlying sinus bone in nasal polyposis (NP). Our evaluation of computed tomography (CT) revealed that the maxillary arch is more flat and shallow in patients with chronic rhinosinusitis with NP. The purpose of this study was to determine the possible effects of NP to the maxillary arch morphology in adulthood and to investigate a possible remodeling of the maxillary bone during the course of NP. METHODS A prospective study was performed on 25 patients. Grading of the polyps, acoustic rhinometry and rhinomanometry assessments, and CT scans were documented initially, 1 year after diagnosis, and 2 years postoperatively. Twenty-five subjects' CT scans randomly selected from our CT database formed the comparison group. The plane angle between the maxillary alveolar processes (MAP) and the palatine process of the maxillary bone (MPP), and the depth of the maxillary arch of both groups were compared. RESULTS The results pointed out that the maxillary arch was shallower and the bilateral angles between MAP and MPP were significantly greater than those of the comparison group in all evaluation periods. This difference was less at the end of the postoperative follow-up period. CONCLUSION Although it is a common belief that maxillofacial formation expires in childhood, this may not be the case under some special conditions such as NP in adulthood. NP might cause maxillary arch remodeling in adults.
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Affiliation(s)
- Kivanc Gunhan
- Department ofOtorhinolaryngology, Celal Bayar University, Dogu Cad. No. 3, Manisa, Turkey.
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