The Relationship Between Adenoid Hypertrophy And Craniofacial Abnormality

Adenoid is a group of lymphatic tissue,which is located in the junction of the top and back wall of nasopharynx,and in the middle of both sides of pharyngeal recess.Adenoid hypertrophy is a kind of pathological hyperplasia,which is resulted from repeated infection and inflammation.The morbidity of adenoid hypertrophy is between 9.9% and 29.9%.It happens as a result of the infection of throat and the simulation of inflammation.Adenoid is one of the components of the immune system.Many parents worry that the immune system will be influenced because of the remove of adenoid,they are also afraid of the trauma and risks brought by the operation.However,adenoid hypertrophy will lead to otitis media,which results in decline of children’s hearing.Adenoid hypertrophy can also obstruct posterior nares that will promote the rhinitis.What’s more,adenoid hypertrophy is one the main reasons of children obstructive sleep apnea-hypopnea syndrome(OSAHS).This disease may cause profound effects in physique and psychology,Because it almost lasts through the whole process of children’s growth and development.Mouth breathing caused by adenoid hypertrophy will affect the muscle and function of oral,which further influence the craniofacial development of patients and result in the Adenoidectomy face.And this situation is rarely considered in the reference of operation,neither worried by parents.Recently,orthodontists and pediatric dentists are paying more and more attention on the influences brought by obstruction of upper airway in craniofacial growth.They find that a large part of the adolescent patients who ask for treatment have hyperplastic adenoid,and this benefits from the cephalometric radiography which is regularly used in orthodontics,it can show adenoid clearly.That allows orthodontists to estimate how much space of nasopharyngeal section of upper airway is occupied by hyperplastic adenoid.Many experts and scholarships have confirmed that obstruction of upper airway can affect craniofacial morphology,but someone opposes.They simply divided the subjects into experimental group and control group,fail to think about the difference among varying grades of adenoid hypertrophy,neither the mouth breathing factor.Objective : The aim of this study was to supply a clinical indication for adenoidectomy reference by analyzing the relationship between adenoid hypotrophy and craniofacial abnormality.Method : 60 subjects with different degrees of adenoid hypertrophy including 15 subjects with mouth breathing(MB)and 30 subjects without adenoid hypertrophy were collected.The age of these patients ranges from 10 to 14 years old.Estimate the value of A/N,hard and soft tissue of the lateral radiographs.Divide the subjects into three groups depending on the level of adenoid hypotrophy(A Group,A/N<0.60,B Group,0.60≤A/N<0.70,C Group,A/N≥0.70),each group contains 30 subjects.Analysis the relationship between the level of adenoid and the degree of variation of each data,and the difference between subjects has adenoid hypertrophy and mouth breathing and subjects only with adenoid hypertrophy in C Group.Results : U1 NA increased significantly in the B and C Group,and L1 NB increased significantly in the C Group.NPog-SN reduced and GoGn-SN increased significantly in the MB Group.Conclusion : The individuals with adenoid hypotrophy(AN≥7.0)and MB present tendencies towards vertical craniofacial growth,convex profile and mandibular retrusion.To such children,adenoidectomy should be considered before 6 years old,to intervene the formation of dento-maxillofacial growth in time.