Influence of tonsil size on sagittal cephalometric measurements

Abstract

Introduction: The role of tonsils in the origin of sagittal skeletodental abnormalities has been widely discussed in the literature but remains controversial. Data on the probable relationship between enlarged tonsils and the presence of these abnormalities were subjective. The aim of this study was to quantify the relationship between the space occupied by the palatine tonsils and sagittal cephalometric measurements.

Materials and methods: A cross-sectional study was performed on a group of children divided into 5 subgroups according to the standardized tonsillar hypertrophy grading scale. Cephalometric measurements were recorded for each child. Data were analyzed using SPSS 20.0 for Windows. The strength of the association between tonsil grades and quantitative variables was assessed using Spearman's rank correlation coefficient (Rho). The level of significance was fixed at P=0.05.

Results: Lengths SN, t2-p3, h-Gn and Xi-pm, and angles I/F, I/SN, i/M, SNB, SNPog and SNGn were significantly and negatively correlated with grades. The ANB angle, the sagittal position of the pogonion and the angle of facial convexity were significantly and positively correlated with grades.

Conclusion: Early evaluation of tonsil size can prevent certain skeletodental abnormalities in the sagittal plane caused by upper airway obstruction. Thus, more aggressive late treatments, which are not always as effective as when they are performed during childhood, can be avoided.

Keywords: Cephalometrics; Oropharynx; Palatine tonsils; Sagittal plane.