The Effect Of Adenoid Hypertrophy With Mouth Breathing On Dentofacial And Craniofacial Development

Objective: To observe the influence of the adenoid hypertrophy on the morphology of the craniomaxillofacial in children during the developmental period,as well as the aging changes under the influence and choosing the best time for surgical treatment of adenoid hypertrophy.Methods: The children in this area who are in the growth period suffering from adenoid hypertrophy(A/N>0.6)and the habitual of mouth breathing are selected as the research objects.Through clinical history,oral and breathing habits examination,nasopharyngeal examination(including X-ray lateral imaging examination),98 children who meet the acceptance criteria were selected randomly as the experimental group for this study,children with normal nasal breathing were selected as healthy control group,X-ray lateral cranial radiographs were taken under the same conditions,the Uceph software was used for measurement.Based on the X-ray cephalometric film,analysis was performed by marking specific marker points,lines,angles,etc.,the ratio of A/N on the lateral radiograph and various cephalometric indicators of Jarabak’s analysis were measured.To observe whether all children with adenoid hypertrophy and mouth breathing would have maxillofacial deformities;at the same time,the quantitative analysis of cervical spine bone age was used to make sure that the children were in the growth period.Taking local healthy children as a reference,the Jarabak cephalometric analysis method was used to conduct a comparative analysis of the experimental group of children,in order to determine the craniofacial characteristics and growth trends of children with adenoid hypertrophy and mouth breathing,applying statistics to analyze the difference of the development of craniofacial characteristics between the healthy and experimental group.At the same time,the cervical spine bone age quantitative analysis method is used to group children with different bone age to longitudinally analyze the differences between the groups,and whether the differences in craniofacial development of these children at different development stages are the same;to explore the effect of adenoid hypertrophy and mouth breathing on craniofacial development and the mechanism of deformity and the timing of treatment.Results: Compared with healthy children,children with adenoid hypertrophy and mouth breathing,Ar-Go-Me↑,N-Go-Me↑,S-Ar-Go↑,SNB°↓,S-Ar↑,N-Go↑,S-Go/N-Me↓ the differences are statistically significant.In children at different developmental stages,N-Go-Me,N-Me,and Go-Me in the experimental group have obvious differences with the increase of cervical vertebral maturation: the measured values of N-Go-Me,Go-Me,N-Me and N-Go,there were statistical differences in QCVM Ⅰ Ⅲ groups,and N-Go-Me also had statistical differences among QCVM Ⅱ Ⅲgroups(P=0.05).When compared with the healthy children group,it was found that S-Ar-Go showed significant differences in the early stages of development,N-Go-Me and Go-Me had significant differences in QCVM III and N-Me in QCVM II.Conclusion: Children with adenoid hypertrophy and mouth breathing are more likely to have craniofacial malformations when A/N>0.6.In terms of development,the skeletal type Ⅱ facial type is most common,which manifests as the retraction of the mandible,the increasing of the mandibular angle,and the lack of development of the length of the mandible.The degree of craniofacial deformity is slightly different at different skeletal age maturity stages,and the difference increases as of the skeletal age.The craniofacial abnormalities of children of different bone age stages are roughly the same,and the obvious increase in mandibular angle can be observed in the early stage of development,but with the increase of cervical vertebral maturation,the mandibular body becomes shorter,the Anterior facial height increases,and the trend of mandibular rotation becomes more and more obvious.Therefore,if the mouth breathing behavior and abnormal craniofacial development can be detected as early as possible.For children who can undergo adenoid hypertrophy resection,the timing of surgical resection is best before growth and development,so as to avoid the increase in deformity.