The Effect Of Adenoid Hypertrophy On Teenager Cranio-facial Morphology And Respiratory Function

Objective: 50 patients before or at growth spurt with obvious cranio-facial abnormality and adenoid hypertrophy are selected for this study. Cephalometry,electric nasopharyngoscope, and portable polysomnography are used to measure cranio-facial and airway morphology;To analysis the difference between cephalometry and electric nasopharyngoscope in the use of evaluating the adenoid hypertrophy through the analysis of the respiratory function. And discuss the three methods to diagnose adenoid hypertrophy and its impact on cranio-facial morphology and respiratory function. To find an effective multi-disciplinary way to diagnose and treat malocclusion with adenoid hypertrophy.Methods: 50 patients before or at growth spurt with obvious cranio-facial abnormality and adenoid hypertrophy are selected for this study. Analyze the age, sex,weight, sleep and respiratory status of these patients. Analyze the vertical skeletal facial type, arch width, palate height by clinical examination. Diagnose adenoid hypertrophy by both cephalometry (A/N value) and electric nasopharyngoscope, and then divide 50 patients into two groups according to the difference between the two methods (T1: adenoid filled postnaris <50%; T2: adenoid filled postnaris?50%). 38 subjects were measured to compare cranio-facial and airway data and processed by SPSS 22.0.1. Results: 1?The 50 patients in this study contains 28 male and 22 female, with age 8-13. Patients have different skeletal patterns, with greater proportion of skeletal type ? (31 patients, 62%) and high angle (increased MP-PH). Clinical examination showed that 38 patients with long and narrow face, 39 with narrow arch and high palate, 28 with small nostril, 25 with snoring, 34 with mouth breathing during sleep, 37 with no family history.2?According to the nasopharyngoscope report from the ENT department of the Affiliated Hospital of KMMU, patients were divided into: group T1: adenoid filled postnaris < 50%; group T2: adenoid filled postnaris ?50%. The difference between(Compared data regarding) cranio-facial and airway measurements showed with no statistical significance except for PNS-ad2 (P<0.01)3. Examination with portable polysomnography of the 50 patients showed that patients with adenoid hypertrophy all suffers from different degree of snoring,hypoventilation (mainly obstructive hypoventilation, central hypoventilation and mixed hypoventilation with no more than 0.2 time/h),and with decreased oxyhemoglobin saturation, suggesting that the patients have respiratory function abnormality.Conclusions: 1?Adenoid hypertrophy could cause obstruction of upper airway in patients at growth spurts and leads to mouth breathing. This has impacts on the development of cranio-facial and upper airway morphology, with more presenting with skeletal type ? and high angle appearance.2?Cephalometry, electric nasopharyngoscope, and portable polysomnography are frequently used to evaluate patients adenoid hypertrophy and respiratory functions in children. The result measured by cephalometry a and electric nasopharyngoscope differs in practice.3?This study used portable PSG to analyze patient's respiratory function,which provided scientific basis for the diagnosis and treatment for malocclusion patients with adenoid hypertrophy.