P001 Palatal growth tool for early sleep-disordered breathing care

Introduction A high, narrow palate is a recognised contributor to paediatric sleep-disordered breathing (SDB). Maxillary expansion has been shown to alleviate SDB, yet “normal” palatal limits are undefined, leaving clinicians without an objective threshold for timely referral. The current status quo is the clinician looking up into the palate and deciding subjectively. Age- and sex-specific reference curves can flag palatal constriction early and guide preventive expansion. Methods We retrospectively reviewed 619 computed-tomography sinus and facial-bone scans from patients aged 0–18 years. After excluding syndromic, surgically altered or incomplete scans, 193 scans (79 female, 114 male) remained. 11 distances and angles were measured following Frankfurt-plane standardisation. Penalised-spline regression modelled age and sex effects. Correlated measurements were combined into a single palatal-shape score, to simplify clinical application. Results Craniofacial dimensions expanded rapidly from birth to approximately 2 years, plateaued, then surged again in adolescence. Sex influenced every measurement except maximal sagittal and anterior coronal palatal angles (p>.10). A “Palatal Shape Score” was generated, weighted chiefly by the anterior coronal angle to simplify clinical use. Reference centile charts and growth-rate plots were created for each variable and for the composite palatal-shape score. Discussion These normative curves enable clinicians to plot an individual child’s palate against normative standards; values outside the 5th or 95th centile indicate an abnormally vaulted palate and warrant referral for consideration of early maxillary expansion to mitigate future SDB. It could be used in both urban and remote settings, supporting timely screening and intervention.