Influence of adenotonsillar hypertrophy on dentofacial development of children

Many attempts have been made to establish a causal relationship between dentofacial abnormalities and adenotonsillar hypertrophy. We investigated the growth pattern in various planes of the facial profile in children with enlarged adenoids and tonsils by mean of serial cephalometric analyses. Special attention was given to characterize the degree of facial dysmorphology and determine the consequences of surgical intervention. Total 134 children with adenotonsillar hypertrophy who had no history of orthodontic treatment were enrolled. All patients underwent serial cephalometric studies and radiographic landmarks were traced for the angular and linear measurements. The children with adenotonsillar hypertrophy showed a more retrognathic maxilla and mandible against cranial base, a more vertically directed facial growth pattern and higher posterior mandibular inclination than controls. Higher proclination of the upper incisor was observed in children with adenotonsillar hypertrophy aged over 10 years. These differences appeared to be normalized with age in children who underwent adenotonsillectomy at age 4 to 6 years with exception of dental changes. The present study suggests that dentofacial abnormalities are associated with adenotonsillar hypertrophy during development, which shows age-dependent specific morphological alterations.