Posts Tagged ‘growth’

Adenoidectomy and Facial Growth

Monday, March 14th, 2011

At the same meeting of the Angle Society, Orlando 2011, as Part 2 of the work of the relationship betweenthe airway of the nasopharynx and craniofacial growth , discussed a review of the literature in recent 25 years on this subject as controversial as:adenoids – mouth breathing and facial growth.

Subtle (1954)y Linder-Aronson(1970) describe “cara adenoidea”, due to hypertrophic adenoids,involving mouth breathing by nasal obstruction,so, is formed with the growth of the child a long, narrow face. However, this juncture and association of symptoms has been discussed by many authors. In the article by Aronson (1979) and a Solow (1984) mentioned that the changes exist in the craneofacies is due to some changes”mechanical” leading to “cara adenoidea”;so there is a disturbance of muscle balance of the face, creatadenoid facete and a lower tongue position, which produces an imbalance between the cheeks and tongue, thereby causing a downward mandibular position and head extension. All this,coming from a lack of nasal breathing by a blockage of the upper respiratory tract or nasopharynx. It also notes that, to remove the adenoids and adenoidectomy, nasal breathing increases, increasing growth and closing the mandibular plane of the jaw, thereby helping to close the open bite.

In 2006, Zettergren-Wijk reported that after 5 years of performing adenoidectomy, the plane of the mandible decreases by increasing the posterior facial height, although increased anterior facial height remains. After the adenoidectomy, there is an increase of the mediators of growth hormone, Insulin Growth Factor 1, and Insulin Growth Factor 1 BP (bounded protein), the latter travels through the bloodstream to accompany a protein. These mediators are set to the masticatory muscles with increased activity, the masseter and medial pterygoid, resulting in increased somatic growth. Thus in the condyle, create an endochondral growth and the gonion, appositional growth (Vogl, 1993), thus increasing posterior facial height and mandibular plane closed. So, from 2006, states that the craniofacial growth disturbances post-adenoidectomy should be some changes”Metabolic” of growth hormone, and not to changes “mechanical” described in 70 and 80.

Study of the airway of the nasopharynx and Craniofacial Growth

Tuesday, February 15th, 2011
Dr. Andreu Font

Dr. Andreu Font during about Exposición

At the last meeting of the Angle Society of America( Orlando, 2011)presented the research to see how it affects the airway from the nasopharynx to the growth of the face , this breathing impaired by the increase of the adenoids (0 vegetations) .There was a study 30 pares de gemelos monocigòticos, having made a selection of the sample on 177 pares de gemepairs of monozygoticejected 77 pairs having no radiological records for 2 more years to keep track of these twins. Of these, 47 pairs were rejected by submitting the following variables: nasal allergies(rhinitis), deviated septum, inferior turbinate hypertrophy, operation of tonsils and / or adenoids in one of the twins (tonsilo-adenoidectomia), craniofacial trauma and other medical findings that could interfere with breathing and / or growth of the face; being selected by both 30 As mentioned above pairs. In this population sample were applied more stringent statistical scales to carry out the study. The study hypothesis was as follows: making a study of monozygotic twins, or , people who are biologically the same, the finding of a difference in craniofacial structures we may deduce that, these differences would craneofacies face or due to a difference in the space of the nasopharynx (the nasopharynx). In other words, if one twin were different than the other in some measure of face, this difference would be due to an alteration in the back of the airway because of adenoidal nasopharyngeal, as,the sample was in a very precise and pure, without interference from other assessments that would mask the final , and therefore, the conclusions of the study.

The conclusions after analyzing the results, were as follows:alterations in the face detected by other researchers, Our research did not detect; instead just some of the 54 Measurements of craneofacies were significant and related to the airway of the nasopharynx; two of these measurements were in the field of the nasopharynx, and three of them were in craniofacial structures, away from the field studied nasopharyngeal. Then, we conclude that alterations in the growth of the face, called “adenoid face” is not due to an alteration or change in breathing pattern, being indifferent mouth breathing or nasal. To say that, alterations in the growth of the face are due to genetic factors predisposing,environmental factors and not per se, as the increased size of the adenoids (hipertrofia adenoidal).

Dr. Hartfield & Dr. Jacobson Question Time.