Structural Analysis Of Upper Airway In Children With Adenoidal Hypertrophy And Its Impact On The Development Of Maxillofacial

Objectives:1. Analyzing the structure of upper airway in children with adenoidal hypertrophy by using the cephalometrical film;2. Researching the effect caused by mouth breathing due to adenoid hypertrophy maxillofacial development;3.To investigate the head posture position, mouth breathing and facial deformities relationship between the three.Methods:Experiment I: Object of study from treatment in the Dental Hospital of Shanxi Medical University Orthodontics patients from January 2012 to January 2015, and was divided into case group(adenoidal group) and control group(control group). Case group(30 cases),aged 4 to 10 years(mean age 7.03 ± 1.82y), 16 males and 14 females, and the A / N value ≥0.71, the children with a history of orthodontic treatment was not included in the study. Control group of 30 patients, aged 4 to 10 years(mean age 7.57 ± 1.65y), 15 males and 15 females, and the A / N value <0.70,.The required data designated by the same physician measured,and incluced: 1.A(lower edge of the adenoids most salient points to the vertical distance between the ramp outside the occipital skull tangent, that adenoid thickness.) 2.N(roots and ramp outside the skull flap after the connection point to the nasal spine points length, bone nasopharyngeal cavity width) 3.PNS-R(posterior nasal spine point- pharyngeal roof pitch), 4.PNS-UPW(posterior nasal spine point-from the pharyngeal wall), 5.SPP-SPPW(after soft palate- the soft palate from the posterior pharyngeal wall), 6.U-MPW(uvula tip-the pharyngeal wall distance), 7.TB-TPPW(airway clearance), 8.V-LPW(epiglottis Valley- swallow wall distance). All the data was inputing SPSS17.0 statistical software for statistical analysis.Experiment II:Selecting 25 mouth breathing children(15 males, 10 females) who was met inclusion criteria from adenoidal group, and then selecting25 nasal breathing children from normal control group,(15males, 10femals), the cephalometrical film of 50 children was transmitted to Win Ceph8.0 cephalometric software, the data was measured by the same Orthodontics,and including ten angle indicators, SNB, ANB, NP-FH, MP-SN, PP-SN, Ar-Co-Me, U1-SN, L1-MP, Y axis angle, 7 length indicators N-Me, Me-ANS, S-Go, N-Me / S-Go, Me-ANS / N-Me, Go-Gn, Po-NB, All the data was inputing SPSS17.0 statistical software for statistical analysis.Results:The age,sex,height and weight have been statistic processed, the discrepancy are statistic meaningless(P>0.05) for counting but comparability.1. There was significant difference in A, R-PNS and PNS-UPW between case and control groups(p<0.05). A of the adenoidectomy hypertrophy geoup obviously decreased; R-PNS and PNS-UPW of the adenoidectomy hypertrophy group obviously increased; N value and other measurement value of the difference between the two groups have no statistical significance;2. Three kinds of skeletal malocclusion have distributing in the mouth breathing and nasal breathing group, there was no statistically significant difference;3. There was no significant difference in SNA and PP-SN between case and control groups(p>0.05), and U1-SN had significant difference(p<0.01), indicating that there is no significant difference in two groups of children on maxilla development, The mouth breathing group whose the Labial inclination of the incisor was larger than the nasal breathing group.4. There was significant difference in MP-SN、Ar-Co-M、Y axis、N-Me、Me-ANS、N-Me/S-Go and Me-ANS/N-Me between case and control groups(P<0.05).The MP-SN, Y axis and Me-ANS was increased, prompting that the mandibular of mouth breathing group had happened clockwise rotation, for increased pharyngeal cavity width adaptability; S-Go had no statistical significance, prompting that there was no differences between the two groups in S-Go; there were statistically significant differences between the two groups in NP-FH, Go-Gn, Po-NB, and thebreathing group was smaller than the nasal breathing group, prompting that happening chin retrusion in the mouth breathing group;5. Mouth breathing children’s natural posture habits had setting up a protrusion to broadening the pharyngeal cavity width for increasing ventilation.Conclusions:1. Adenoid hypertrophy mainly had influenced the soft structure of nasopharyngeal, causing the nasopharyngeal cavity stenosis, and triggered a series of complications; The airway structura can be measured by cephalometrical film easily and accurately.2. Three kinds of skeletal malocclusion have distributing in the mouth breathing and nasal breathing group, there was no statistically significant difference; Mouth breathing method for maxillofacial growth mainly aimed at the influence of the mandible, can cause after mandibular rotation or extension forward, causing the front 1/3 height increased and Go-Gn decreased, and upper and lower anterior teeth was flared, and little influence on maxillary growth; Head posture, breathing pattern and maxillofacial development relationship among closely, mouth breathing children cranial neck Angle larger than normal children, head posture was stretched upward normally.