Investigation of the effects of respiratory obstruction due to adenoid hypertrophy on craniofacial morphology, respiratory pattern, and posture

Aim The purpose of this thesis study is to evaluate the respiratory pattern changes, craniofacial morphological development, and head-neck and general body posture of children who have undergone early adenoidectomy due to respiratory obstruction caused by adenoid hypertrophy, those who have been indicated for adenoidectomy but not operated on, and children with normal nasal breathing. Materials and Methods This multidisciplinary study included the Departments of Otolaryngology, Physical Therapy and Rehabilitation, and Orthodontics. Patients diagnosed with adenoid vegetation who did not undergo surgery (Group 1) and those who underwent early surgery (Group 2) were selected. The study groups were compared with a control group (Group 3) consisting of individuals with no pathology causing respiratory obstruction and normal nasal breathing. The average ages are as follows: Group 1: 31 participants (13 female, 17 male), 7.9±1.55 years; Group 2: 30 participants (13 female, 17 male), 8.1±1.47 years; Group 3: 30 participants (14 female, 16 male), 8.3±1.39 years. Cephalometric & posteroanterior films and dental models were obtained from the patients. For respiratory assessment, the NOSE scale and peak nasal flow meter were used. Posture analysis of the included patients was conducted using 3D motion analysis system technology with "Kinect sensors." Results Significant differences were observed between the groups in terms of SNA°, PP-SN°, FMA°, posterior face height (mm), and anterior face height (mm) values (p<0.05). In P-A analysis, significant differences were found in the intergonial distance between Groups 1 and 2, and in model analysis, significant differences were observed in the distance between the upper canines (UR3-UL3) between Groups 2 and 1 and 3 (p<0.05). Significant differences were found between Groups 1 and 2 and 3 in the NOSE scale measurements (p<0.05). In the Visual Analog Scale (VAS) assessment of nasal respiratory function by the patients, significant differences were observed between Groups 1 and 2 and 3 (p<0.05). Similarly, significant differences were found between Groups 1 and 2 and 3 in the peak nasal flow meter (PNIF) measurements. However, no significant differences were observed between the groups in the posture analysis (p>0.05). Conclusion In the long-term follow-up of patients who underwent early adenoidectomy, 13.3% could not switch from mouth breathing to nasal breathing. In patients where adenoidectomy was delayed, limited nasal breathing persisted. A positive correlation was observed between the measurements taken with peak PNIF and the scores on the NOSE scale across all groups included in the study. No differences were found in posture analysis between the groups. In patients needing adenoidectomy but whose surgery was delayed, an increase in vertical dimensions, counterclockwise rotation in the maxilla, and increased sagittal maxillary growth were observed. Keywords: Adenoid, mouth breathing, posture.