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. 2024 Sep 17:13:35.
doi: 10.4103/jos.jos_20_24. eCollection 2024.

Cephalometric differences in grades II and IV adenoid hypertrophy: A cross-sectional study

Afnan R Hammood  1 , Hayder F Saloom  1
Affiliations

Cephalometric differences in grades II and IV adenoid hypertrophy: A cross-sectional study

Afnan R Hammood et al. J Orthod Sci. .

Abstract

Objectives: This study aims to determine whether there were cephalometric changes between grades II and IV adenoid hypertrophy.

Methods and materials: A cross-sectional study was conducted on 120 6-12-year-old patients selected from the ear, nose, and throat department at Imam Al-Hussein Medical City in Karbala. Patients were classified into three groups (each = 40) based on endoscopic findings: control, grade II, and grade IV. The findings were confirmed with cephalometric radiographs. Specific cephalometric points were identified to measure sella-nasion-point A (SNA), sella-nasion-point B (SNB), point A-nasion-point B (ANB), sella-nasion-pogonion (SNPog), sella nasion plane-palatal plane (SNPP), palatal plane-mandibular plane (PPMP), sella nasion plane-mandibular plane (SNMP), saddle, articular, gonial angles, and the y-axis. Additionally, superior-posterior airway space (SPAS), posterior air way space (PAS), mandibular plane-hyoid bone (MP-H), third cervical vertebra-hyoid bone (C3-H), total anterior facial height (TAFH), total posterior facial height (TPFH), upper anterior facial height (UAFH), lower anterior facial height (LAFH), and the Jarabak ratio were measured.

Results: Analysis of variance (ANOVA) and Welch tests indicated statistically significant differences (P < 0.05) among the three groups in SNA, SNB, SNPog, PPMP, SNMP, gonial angle, y-axis, SPAS, PAS, MP-H, and the Jarabak ratio. Tukey's honestly significant difference (HSD) and Games-Howell tests indicated a statistically significant difference between grade II and grade IV in SNA, SNMP, y-axis, SPAS, PAS, MP-H, and Jarabak ratio.

Conclusion: The present study demonstrated that craniofacial changes start to occur at the moderate adenoid enlargement throughout the downward backward mandibular rotation. More changes would become evident at the severe stage; therefore, an urgent medical intervention and the establishment of nasal breathing by orthodontic treatment with breathing activity would be needed.

Keywords: Adenoid hypertrophy; cephalometric radiograph; cross-sectional study; mouth breather.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Diagram of the endoscopic grading of adenoid hypertrophy[22]
Figure 2
Figure 2
Cephalometric radiograph of the angular measurements modified[27]
Figure 3
Figure 3
Drawing of the linear measurements of the airways. 1, SPAS; 2, PAS; 3, MP-H; 4, C3-H[7]
See this image and copyright information in PMC

References

    1. Robb P. Adenoidectomy: Does it work? J Laryngol Otol. 2007;121:209–14. - PubMed
    1. Acar GÖ, Cansz H, Duman C, Öz B, Cigerciogullar E. Excessive reactive lymphoid hyperplasia in a child with persistent obstructive sleep apnea despite previous tonsillectomy and adenoidectomy. J Craniofac Surg. 2011;22:1413–5. - PubMed
    1. Van den Aardweg MT, Boonacker CW, Rovers MM, Hoes AW, Schilder AG. Effectiveness of adenoidectomy in children with recurrent upper respiratory tract infections: Open randomised controlled trial. BMJ. 2011;343:d5154. doi: 10.1136/bmj.d5154. - PMC - PubMed
    1. Grippaudo C, Paolantonio EG, Antonini G, Saulle R, La Torre G, Deli R. Association between oral habits, mouth breathing and malocclusion. Acta Otorhinolaryngol Ital. 2016;36:386–94. - PMC - PubMed
    1. D’Ascanio L, Lancione C, Pompa G, Rebuffini E, Mansi N, Manzini M. Craniofacial growth in children with nasal septum deviation: A cephalometric comparative study. Int J Pediatr Otorhinolaryngol. 2010;74:1180–3. - PubMed

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