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Computed tomographic evaluation of mouth breathers among paediatric patients
1Department of Oral Medicine, Periodontology, Diagnosis and Radiology, Faculty of Dentistry, Ain Shams University, Cairo, Egypt. marymedhat3@yahoo.com
Insights
Enlarged adenoids are a primary cause of mouth breathing in children. However, other mechanical issues like sinusitis and septal deviation also contribute, even in cases without adenoid hypertrophy.
Area of Science:
- Otolaryngology
- Pediatric Pulmonology
- Radiology
Background:
- Mouth breathing in children is linked to significant health issues.
- Enlarged adenoids are widely considered the main cause of pediatric mouth breathing.
- This study investigates additional mechanical factors contributing to mouth breathing.
Purpose of the Study:
- To evaluate mechanical obstacles beyond enlarged adenoids that may cause mouth breathing in children.
- To identify the prevalence of various anatomical and inflammatory changes in pediatric mouth breathers.
Main Methods:
- 67 children (10-15 years) were categorized into mouth-breathers and nose-breathers.
- Axial CT scans of the brain and limited coronal CT scans of paranasal sinuses were performed.
- Congenital variations and inflammatory changes were assessed.
Main Results:
- 87% of mouth-breathers had enlarged adenoids; other common findings included maxillary sinusitis (77%) and deviated nasal septum (55%).
- Significant differences in these conditions were observed between mouth-breathers and nose-breathers.
- Notably, 12.9% of mouth-breathers lacked adenoids, with some showing normal CT scans, indicating habitual mouth breathing.
Conclusions:
- While enlarged adenoids play a major role, other mechanical factors are significant contributors to pediatric mouth breathing.
- Pediatricians should consider non-adenoid-related mechanical obstacles if mouth breathing persists post-adenoidectomy.
- Further research is needed to confirm the efficacy of correcting these factors on children's quality of life.
Objectives:
Mouth breathing causes many serious problems in the paediatric population. It has been maintained that enlarged adenoids are principally responsible for mouth breathing. This study was designed to evaluate whether other mechanical obstacles might predispose the child to mouth breathing.
Methods:
67 children with ages ranging from 10 to 15 years were studied and grouped into mouth-breathers and nose-breathers. The children first underwent axial CT scans of the brain for which they were originally referred. In addition, they were subjected to a limited coronal CT examination of the paranasal sinuses. Congenital anatomical variations as well as inflammatory changes were assessed.
Results:
87% of mouth-breathing children had hypertrophied adenoids, 77% had maxillary sinusitis, 74% had pneumatized middle concha, 55% had a deviated nasal septum, 55% had hypertrophied inferior conchae, 45% had ethmoidal sinusitis and 23% showed frontal sinusitis. Such changes were significantly less prevalent in nose-breathers. 12.9% of mouth-breathing children did not have adenoids. Of these children, only 3.3% had one or more congenital or inflammatory change whereas the other 9.6% showed a completely normal CT scan signifying the incidence of habitual non-obstructive mouth breathing.
Conclusions:
It is clear that adenoids have a dominant role in causing mouth breathing. Yet, we recommend that paediatricians should assess other mechanical obstacles if mouth breathing was not corrected after adenoidectomy. Further research should be performed to test the validity of correction of such factors in improving the quality of life of mouth-breathing children.
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